Provider Demographics
NPI:1124531439
Name:BEER DERMATOLOGY ASSOCIATES PA
Entity type:Organization
Organization Name:BEER DERMATOLOGY ASSOCIATES PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KENNETH
Authorized Official - Middle Name:R
Authorized Official - Last Name:BEER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-932-1707
Mailing Address - Street 1:641 UNIVERSITY BLVD
Mailing Address - Street 2:SUITE 212
Mailing Address - City:JUPITER
Mailing Address - State:FL
Mailing Address - Zip Code:33458
Mailing Address - Country:US
Mailing Address - Phone:561-932-1707
Mailing Address - Fax:561-932-1711
Practice Address - Street 1:641 UNIVERSITY BLVD
Practice Address - Street 2:SUITE 212
Practice Address - City:JUPITER
Practice Address - State:FL
Practice Address - Zip Code:33458
Practice Address - Country:US
Practice Address - Phone:561-932-1707
Practice Address - Fax:561-932-1711
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-11-08
Last Update Date:2017-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME59480207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Single Specialty