Provider Demographics
NPI:1306475975
Name:BIDGOOD, BEATRIZ APONTE (PA-C)
Entity type:Individual
Prefix:
First Name:BEATRIZ
Middle Name:APONTE
Last Name:BIDGOOD
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17 MARSHLAND POINTE
Mailing Address - Street 2:
Mailing Address - City:POOLER
Mailing Address - State:GA
Mailing Address - Zip Code:31322-3685
Mailing Address - Country:US
Mailing Address - Phone:919-324-5500
Mailing Address - Fax:
Practice Address - Street 1:17 MARSHLAND POINTE
Practice Address - Street 2:
Practice Address - City:POOLER
Practice Address - State:GA
Practice Address - Zip Code:31322-3685
Practice Address - Country:US
Practice Address - Phone:919-324-5500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-04-06
Last Update Date:2021-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA9604363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant