Provider Demographics
NPI:1831795871
Name:BECTON, ERIC MARTIN (CRNA)
Entity type:Individual
Prefix:
First Name:ERIC
Middle Name:MARTIN
Last Name:BECTON
Suffix:
Gender:M
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:86 SW 8TH ST UNIT 4707
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33130-4517
Mailing Address - Country:US
Mailing Address - Phone:901-489-1019
Mailing Address - Fax:
Practice Address - Street 1:3663 S MIAMI AVE
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33133-4237
Practice Address - Country:US
Practice Address - Phone:305-854-4400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-12-06
Last Update Date:2024-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11011387367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered