Decordova, Beth Ann
Decordova, Beth Ann is an individual health care provider with primary practice located at 1421 Malabar Rd Ne , Palm Bay FL 32907-2576. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Adult Health, which is considered as her primary health care specialty. Decordova, Beth Ann can be contacted via phone (321) 434-8531.Contact Information
Primary practice address
1421 Malabar Rd Ne
Palm Bay FL 32907-2576
Phone: (321) 434-8531
Fax: (321) 434-8533
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Adult Health | 363LA2200X | APRN9433193 | Florida |
Profile Details
| NPI number | 1518207943 |
|---|---|
| LBN Legal business name | Decordova, Beth Ann |
| Credentials | Nurse Practitioner (NP) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Feb 21st, 2013 |
| Last updated | Jul 23rd, 2024 - about 2 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1518207943 | NPPES |
| Florida | MEDICAID | 019314300 | |
| Florida | Other | IU177Z |
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