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Contact Information

LAURA N BEVERLY, MD
1522 PENMAN RD.
JACKSONVILLE BEACH, FL32250
 Phone: 904-253-2555
 Fax: 904-270-2559
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Pediatrics

208000000X 37 Physician/Pediatric Medicine
Indicates primary specialty

NPI Profile & details for LAURA N BEVERLY · (Female)

NPI Number 1235189861
Status Active
Credentials MD
Entity Individual
Enumeration date 05/12/2006
Last updated 01/02/2013 - About 13 years ago
Sole proprietor 1 No
Identifiers
  • FL License # ME59866
  • FL Medicaid 3740781-01
  • FL Medicaid 374078101
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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