Basic Information
| Provider Information | |||||||||
| NPI: | 1003178674 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BEESLEY | ||||||||
| FirstName: | STEVEN | ||||||||
| MiddleName: | D. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 9007 | ||||||||
| Address2: | |||||||||
| City: | CHARLOTTESVILLE | ||||||||
| State: | VA | ||||||||
| PostalCode: | 229069007 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4342951000 | ||||||||
| FaxNumber: | 4349724266 | ||||||||
| Practice Location | |||||||||
| Address1: | 86 W UNDERWOOD ST | ||||||||
| Address2: | SUITE 201, 2ND FLOOR | ||||||||
| City: | ORLANDO | ||||||||
| State: | FL | ||||||||
| PostalCode: | 328061110 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3218415142 | ||||||||
| FaxNumber: | 4076483686 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/11/2012 | ||||||||
| LastUpdateDate: | 07/03/2017 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2085R0202X | 0101261934 | VA | Y | Allopathic & Osteopathic Physicians | Radiology | Diagnostic Radiology | 390200000X | TRN17647 | FL | N | Student, Health Care | Student in an Organized Health Care Education/Training Program |
No ID Information.