Organization · NPI-2

Beacon MD LLC

Internal Medicine · Fort Pierce, FL

NPI number1710734496
StatusActive
Last updated in NPPESFeb 18, 2026

Details

NPI
1710734496
Entity type
Organization (NPI-2)
Legal business name
Beacon MD LLC
Organization subpart
No
Enumeration date
May 1, 2024
Certification date
Feb 18, 2026
Last updated
Feb 18, 2026

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
207R00000X Internal Medicine––Yes
207Q00000X Family Medicine––
2084N0400X Psychiatry & Neurology, Neurology––
207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism––

Practice location

2011 S 25th St Ste 106
Fort Pierce, FL 34947-4795

Phone 772-229-4770

Mailing address

2011 S 25th St Ste 105
Fort Pierce, FL 34947-4795

Phone 772-229-4770

Authorized official

Ajay Goyal
President
7724687020

Is something wrong?

This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.

Other Internal Medicine providers in Fort Pierce, FL