| Shaughn C Bennett Do Pa | |
|
7575 Sw 62nd Ave Suite B South Miami FL 33143-4955 | |
| (305) 661-0181 | |
| Not Available |
| Full Name | Shaughn C Bennett Do Pa |
|---|---|
| Speciality | Family Medicine |
| Location | 7575 Sw 62nd Ave, South Miami, Florida |
| Authorized Official Name and Position | Shaughn C Bennett (OWNER/PHYSICIAN) |
| Authorized Official Contact | 3059265844 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Shaughn C Bennett Do Pa 7575 Sw 62nd Ave Suite B South Miami FL 33143-4955 Ph: (305) 661-0181 | Shaughn C Bennett Do Pa 7575 Sw 62nd Ave Suite B South Miami FL 33143-4955 Ph: (305) 661-0181 |
| NPI Number | 1639342645 |
|---|---|
| Provider Enumeration Date | 04/10/2008 |
| Last Update Date | 04/10/2008 |
| Medicare PECOS PAC ID | 4082753546 |
|---|---|
| Medicare Enrollment ID | O20091123000694 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1639342645 | NPI | - | NPPES |
| 1891758132 | Other | FL | NPI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | OS5245 (Florida) | Primary |
| Provider Name | Shaughn C Bennett |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1891758132 PECOS PAC ID: 4385744093 Enrollment ID: I20070711000053 |
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