Basic Information
Provider Information
NPI: 1487833505
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: BEG
FirstName: RASHA
MiddleName: N.
NamePrefix:  
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 102222
Address2: ATTN: CREDENTIALING
City: ATLANTA
State: GA
PostalCode: 303682222
CountryCode: US
TelephoneNumber: 2392748200
FaxNumber:  
Practice Location
Address1: 2572 W STATE ROAD 426 STE 3080
Address2:  
City: OVIEDO
State: FL
PostalCode: 327658312
CountryCode: US
TelephoneNumber: 4075652192
FaxNumber: 4075652285
Other Information
ProviderEnumerationDate: 10/25/2007
LastUpdateDate: 08/02/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 08/02/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207RX0202XME99726FLY Allopathic & Osteopathic PhysiciansInternal MedicineMedical Oncology

ID Information
IDTypeStateIssuerDescription
28007480005FL MEDICAID


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