Provider Demographics
NPI:1104886035
Name:BENCZE, KATHERINE S (MD)
Entity type:Individual
Prefix:
First Name:KATHERINE
Middle Name:S
Last Name:BENCZE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 272536
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33688-2536
Mailing Address - Country:US
Mailing Address - Phone:813-972-3654
Mailing Address - Fax:813-971-3960
Practice Address - Street 1:13601 BRUCE B DOWNS BLVD
Practice Address - Street 2:SUITE 261
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33613-4657
Practice Address - Country:US
Practice Address - Phone:813-972-3654
Practice Address - Fax:813-971-3960
Is Sole Proprietor?:No
Enumeration Date:2006-03-24
Last Update Date:2012-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME472412084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL592964153OtherTAX ID
FL592964153OtherTAX ID