Theresa A Benedict Llc | |
329 Nokomis Ave S Ste H Venice FL 34285-2418 | |
(941) 830-0165 | |
Not Available |
Full Name | Theresa A Benedict Llc |
---|---|
Speciality | Social Worker |
Location | 329 Nokomis Ave S Ste H, Venice, Florida |
Authorized Official Name and Position | Theresa Ann Croce Benedict (CLINICAL SOCIAL WORKER) |
Authorized Official Contact | 9418300165 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
Theresa A Benedict Llc 2254 Oleada Ct Englewood FL 34224-9074 Ph: (941) 830-0165 | Theresa A Benedict Llc 329 Nokomis Ave S Ste H Venice FL 34285-2418 Ph: (941) 830-0165 |
NPI Number | 1588800098 |
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Provider Enumeration Date | 01/05/2009 |
Last Update Date | 09/05/2023 |
Certification Date | 09/05/2023 |
Medicare PECOS PAC ID | 8820153968 |
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Medicare Enrollment ID | O20090224000475 |
Identifier | Type | State | Issuer |
---|---|---|---|
1588800098 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1041C0700X | Social Worker - Clinical | SW7665 (Florida) | Primary |
Provider Name | Theresa A Croce Benedict |
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Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1427246503 PECOS PAC ID: 5294890331 Enrollment ID: I20090224000462 |
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