Provider Demographics
NPI:1699727743
Name:BENZING, PEGGY (DO)
Entity type:Individual
Prefix:
First Name:PEGGY
Middle Name:
Last Name:BENZING
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1605 MANOR RD
Mailing Address - Street 2:
Mailing Address - City:ENGLEWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:34223-4929
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:8431 POINTE LOOP DR
Practice Address - Street 2:FIRST FLOOR
Practice Address - City:VENICE
Practice Address - State:FL
Practice Address - Zip Code:34293-2232
Practice Address - Country:US
Practice Address - Phone:941-207-5320
Practice Address - Fax:941-207-5321
Is Sole Proprietor?:No
Enumeration Date:2006-05-17
Last Update Date:2016-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS5456207P00000X
FLOS55456207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OS5456Medicare UPIN