Provider Demographics
NPI:1386606366
Name:BEITELSCHIES, DANNY R (PA-C)
Entity type:Individual
Prefix:
First Name:DANNY
Middle Name:R
Last Name:BEITELSCHIES
Suffix:
Gender:M
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:PO BOX 2147
Mailing Address - Street 2:
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33902-2147
Mailing Address - Country:US
Mailing Address - Phone:239-424-2755
Mailing Address - Fax:239-424-2756
Practice Address - Street 1:708 DEL PRADO BLVD S STE 6
Practice Address - Street 2:
Practice Address - City:CAPE CORAL
Practice Address - State:FL
Practice Address - Zip Code:33990-2661
Practice Address - Country:US
Practice Address - Phone:239-424-2755
Practice Address - Fax:239-424-2756
Is Sole Proprietor?:No
Enumeration Date:2006-04-05
Last Update Date:2021-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPA2032363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLP00449651OtherRAILROAD MEDICARE
FL2900858 00Medicaid
FL4272466OtherAETNA
FL352296OtherAVMED
FLP300286OtherFREEDOM HEALTH
FL61121OtherWELLCARE
FL6862125OtherCIGNA
FLP00449651OtherRAILROAD MEDICARE
S64696Medicare UPIN