BEVERLY ENCARNACION, M.D., P.A.
Ambulatory Health at Main St, Dunedin, FL

License number
Florida ME007280
Category
Ambulatory Health
Type
Primary Care
Owner
Name: BEVERLY ENCARNACION M.D.
Title: OWNER/PRESIDENT
Phone: (727) 736-7733
Address
Address
2128 Main St, Dunedin, FL 34698
National Provider ID: 1306036777
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

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BEVERLY ENCARNACION, M.D., PA

2128 Main St, Dunedin, FL 34698

Status:
Inactive
Industry:
Internist
Doing business as:
Beverly Encarnacion MD
Inactive reason:
AMENDMENT AND NAME CHANGE
Registration:
Aug 31, 1998
Inactive since:
Oct 19, 1998
Phone:
(727) 736-7733 (Phone)
State ID:
P98000076755
Business type:
Florida Profit Corporation
S:
Beverly R Encarnacion, 2128 Main St, Dunedin, FL 34698 (Physical),Elpidio M Loleng, 2128 Main St, Dunedin, FL 34698 (Physical)
Agent:
Elpidio Loleng,2128 Main St, Dunedin, FL 34698 (Physical)
EIN:
593538815

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