Provider Demographics
NPI:1871723700
Name:ANLAS, BETH ELLEN (DO)
Entity type:Individual
Prefix:DR
First Name:BETH
Middle Name:ELLEN
Last Name:ANLAS
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10926 CHARMWOOD DR
Mailing Address - Street 2:
Mailing Address - City:RIVERVIEW
Mailing Address - State:FL
Mailing Address - Zip Code:33569-6254
Mailing Address - Country:US
Mailing Address - Phone:908-797-0768
Mailing Address - Fax:
Practice Address - Street 1:12920 SUMMERFIELD CROSSING BLVD
Practice Address - Street 2:
Practice Address - City:RIVERVIEW
Practice Address - State:FL
Practice Address - Zip Code:33579-7210
Practice Address - Country:US
Practice Address - Phone:813-998-8600
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-27
Last Update Date:2022-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS11611207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine