Basic Information
Provider Information
NPI: 1639376106
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: BEECHER
FirstName: BRETT
MiddleName: ALAN
NamePrefix: DR.
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 9033
Address2:  
City: STUART
State: FL
PostalCode: 349959033
CountryCode: US
TelephoneNumber: 7727812799
FaxNumber: 7727812716
Practice Location
Address1: 501 SE OSCEOLA ST STE 201
Address2:  
City: STUART
State: FL
PostalCode: 349942334
CountryCode: US
TelephoneNumber: 7724192137
FaxNumber: 7724192138
Other Information
ProviderEnumerationDate: 06/28/2007
LastUpdateDate: 10/14/2020
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 10/14/2020

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
208G00000XME137858FLY Allopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery) 

ID Information
IDTypeStateIssuerDescription
Y01R501FLFLORIDA BLUEOTHER


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