| Beacon MD LLC | |
|
2011 S 25th St Ste 106 Fort Pierce FL 34947-4795 | |
| (772) 229-4770 | |
| Not Available |
| Full Name | Beacon MD LLC |
|---|---|
| Speciality | Internal Medicine |
| Location | 2011 S 25th St Ste 106, Fort Pierce, Florida |
| Authorized Official Name and Position | Ajay Goyal (PRESIDENT) |
| Authorized Official Contact | 7724687020 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Beacon MD LLC 2011 S 25th St Ste 105 Fort Pierce FL 34947-4795 Ph: (772) 229-4770 | Beacon MD LLC 2011 S 25th St Ste 106 Fort Pierce FL 34947-4795 Ph: (772) 229-4770 |
| NPI Number | 1710734496 |
|---|---|
| Provider Enumeration Date | 05/01/2024 |
| Last Update Date | 02/18/2026 |
| Certification Date | 02/18/2026 |
| Medicare PECOS PAC ID | 1557846391 |
|---|---|
| Medicare Enrollment ID | O20260331000457 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1710734496 | NPI | - | NPPES |
| Provider Name | Jose Salvador Santos |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1972694644 PECOS PAC ID: 9739270737 Enrollment ID: I20190620001114 |
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