Provider Demographics
NPI:1538202924
Name:BENOIT, BENJAMIN (RPH, CGP)
Entity type:Individual
Prefix:
First Name:BENJAMIN
Middle Name:
Last Name:BENOIT
Suffix:
Gender:M
Credentials:RPH, CGP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10332 BELLWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:NEW PORT RICHEY
Mailing Address - State:FL
Mailing Address - Zip Code:34654-5900
Mailing Address - Country:US
Mailing Address - Phone:727-505-9830
Mailing Address - Fax:
Practice Address - Street 1:10332 BELLWOOD AVE
Practice Address - Street 2:
Practice Address - City:NEW PORT RICHEY
Practice Address - State:FL
Practice Address - Zip Code:34654-5900
Practice Address - Country:US
Practice Address - Phone:727-505-9830
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS26406183500000X
FLPU4831183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist