Provider Demographics
NPI:1285922203
Name:BEECUM, BIJAL (OD)
Entity type:Individual
Prefix:
First Name:BIJAL
Middle Name:
Last Name:BEECUM
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15651 DUNNS POND CT
Mailing Address - Street 2:
Mailing Address - City:ODESSA
Mailing Address - State:FL
Mailing Address - Zip Code:33556-3738
Mailing Address - Country:US
Mailing Address - Phone:727-207-4141
Mailing Address - Fax:
Practice Address - Street 1:1201 COUNTY ROAD 581
Practice Address - Street 2:
Practice Address - City:WESLEY CHAPEL
Practice Address - State:FL
Practice Address - Zip Code:33544-9261
Practice Address - Country:US
Practice Address - Phone:813-994-2614
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-07-11
Last Update Date:2016-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOPC4693152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist