Basic Information
| Provider Information | |||||||||
| NPI: | 1881986800 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | TENNYSON | ||||||||
| FirstName: | NATHAN | ||||||||
| MiddleName: | BEECHAM | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 301 N ATLANTIC DR | ||||||||
| Address2: | |||||||||
| City: | LANTANA | ||||||||
| State: | FL | ||||||||
| PostalCode: | 334621917 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8046150762 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1240 S OLD DIXIE HWY | ||||||||
| Address2: | |||||||||
| City: | JUPITER | ||||||||
| State: | FL | ||||||||
| PostalCode: | 334587205 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5612634400 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 05/10/2011 | ||||||||
| LastUpdateDate: | 08/21/2016 | ||||||||
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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 | 2085R0001X | 128302 | FL | Y | Allopathic & Osteopathic Physicians | Radiology | Radiation Oncology |
No ID Information.