Beaulieu, Jack G.

Beaulieu, Jack G. is an individual health care provider with primary practice located at 657 Del Prado Blvd S , Cape Coral FL 33990-2666. He recently has only one registered license in Allopathic & Osteopathic Physicians / Orthopaedic Surgery, which is considered as his primary health care specialty. Beaulieu, Jack G. can be contacted via phone (239) 772-4484.

Contact Information

Primary practice address
657 Del Prado Blvd S Cape Coral FL 33990-2666
Phone: (239) 772-4484
Fax: (239) 772-2903
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Orthopaedic Surgery 207X00000X ME 0029197 Florida

Profile Details

NPI number 1528064086
LBN Legal business name Beaulieu, Jack G.
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 21st, 2005
Last updated Jul 8th, 2007 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1528064086 NPPES
Florida Other 79304 B/C B/S FLORIDA INSURANCE

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