Mr Roosevelt Bennett Jr, AA-C | |
807 Childrens Way, Nemours Childrens Specialty Care, Jacksonville, Jacksonville, FL 32207-8426 | |
(904) 697-3600 | |
(904) 697-3927 |
Full Name | Mr Roosevelt Bennett Jr |
---|---|
Gender | Male |
Speciality | Anesthesiologist Assistant |
Location | 807 Childrens Way, Jacksonville, Florida |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1184900177 | NPI | - | NPPES |
004228800 | Medicaid | FL |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
367H00000X | Anesthesiologist Assistant | AA100 (Florida) | Primary |
Entity Name | The Nemours Foundation |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1386658615 PECOS PAC ID: 9537072483 Enrollment ID: O20040109000252 |
Entity Name | Us Anesthesia Partners Of Florida Inc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1518910520 PECOS PAC ID: 0345143152 Enrollment ID: O20040129000594 |
Entity Name | Brevard Physician Associates Pllc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1598008955 PECOS PAC ID: 1850535048 Enrollment ID: O20130909000619 |
Mailing Address | Practice Location Address |
---|---|
Mr Roosevelt Bennett Jr, AA-C Po Box 191, Provider Enrollment Department, Rockland, DE 19732-0191 Ph: (904) 697-4201 | Mr Roosevelt Bennett Jr, AA-C 807 Childrens Way, Nemours Childrens Specialty Care, Jacksonville, Jacksonville, FL 32207-8426 Ph: (904) 697-3600 |
Alyssa Kay Burgo, Anesthesiologist Assistant Medicare: Accepting Medicare Assignments Practice Location: 800 Prudential Dr, Jacksonville, FL 32207 Phone: 904-202-2000 | |
Haley Wingo, CAA Anesthesiologist Assistant Medicare: Accepting Medicare Assignments Practice Location: 800 Prudential Dr, Jacksonville, FL 32207 Phone: 904-202-8000 | |
Mr. Kyle Matthew Hillis, CAA Anesthesiologist Assistant Medicare: Accepting Medicare Assignments Practice Location: 820 Prudential Dr Ste 606, Jacksonville, FL 32207 Phone: 904-398-3356 | |
April Jennifer Harris Still, AAC Anesthesiologist Assistant Medicare: Accepting Medicare Assignments Practice Location: 655 W 8th St, Jacksonville, FL 32209 Phone: 904-244-3660 | |
Benjamin Olson Dickey, CAA Anesthesiologist Assistant Medicare: Accepting Medicare Assignments Practice Location: 800 Prudential Dr, Jacksonville, FL 32207 Phone: 904-202-2000 | |
Olga B Carroll, AA Anesthesiologist Assistant Medicare: Accepting Medicare Assignments Practice Location: 655 W 8th St, Jacksonville, FL 32209 Phone: 904-244-0411 | |
William James Morgan, Anesthesiologist Assistant Medicare: Medicare Enrolled Practice Location: 800 Prudential Dr, Jacksonville, FL 32207 Phone: 904-202-2000 |