Provider Demographics
NPI:1841311933
Name:BETSY BEERS MD PA
Entity type:Organization
Organization Name:BETSY BEERS MD PA
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:BETSY
Authorized Official - Middle Name:
Authorized Official - Last Name:BEERS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:352-332-4051
Mailing Address - Street 1:350 NW 76 DR
Mailing Address - Street 2:SUITE A
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32607
Mailing Address - Country:US
Mailing Address - Phone:352-332-4051
Mailing Address - Fax:352-332-2966
Practice Address - Street 1:350 NW 76 DR
Practice Address - Street 2:SUITE A
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32607
Practice Address - Country:US
Practice Address - Phone:352-332-4051
Practice Address - Fax:352-332-2966
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-03
Last Update Date:2007-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207ND0900XAllopathic & Osteopathic PhysiciansDermatologyDermatopathologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLK0200OtherGROUP BILLING
FL68569YMedicare UPIN