Provider Demographics
NPI:1316731847
Name:IGLESIAS, BEVERLY (REGISTERED NURSE)
Entity type:Individual
Prefix:
First Name:BEVERLY
Middle Name:
Last Name:IGLESIAS
Suffix:
Gender:
Credentials:REGISTERED NURSE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2202 LAKE WOODBERRY CIR
Mailing Address - Street 2:
Mailing Address - City:BRANDON
Mailing Address - State:FL
Mailing Address - Zip Code:33510-2707
Mailing Address - Country:US
Mailing Address - Phone:813-841-6496
Mailing Address - Fax:
Practice Address - Street 1:2202 LAKE WOODBERRY CIR
Practice Address - Street 2:
Practice Address - City:BRANDON
Practice Address - State:FL
Practice Address - Zip Code:33510-2707
Practice Address - Country:US
Practice Address - Phone:813-841-6496
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-08
Last Update Date:2025-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN9556356163WI0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WI0500XNursing Service ProvidersRegistered NurseInfusion Therapy