Provider Demographics
NPI:1841292141
Name:BENKERT, CATHERINE ANN (PA)
Entity type:Individual
Prefix:
First Name:CATHERINE
Middle Name:ANN
Last Name:BENKERT
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:CATHERINE
Other - Middle Name:ANN
Other - Last Name:DUNTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1336 RICHWOOD CIR
Mailing Address - Street 2:
Mailing Address - City:ROCKLEDGE
Mailing Address - State:FL
Mailing Address - Zip Code:32955-4493
Mailing Address - Country:US
Mailing Address - Phone:321-432-3624
Mailing Address - Fax:
Practice Address - Street 1:601 E ROLLINS ST
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32803-1248
Practice Address - Country:US
Practice Address - Phone:407-303-7286
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-06-01
Last Update Date:2025-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPA9102192363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL291946000Medicaid
FLE8128YMedicare ID - Type UnspecifiedGROUP # 45368
FLE8128XMedicare ID - Type UnspecifiedGROUP # 34457
FLP70050Medicare UPIN
FLE8128UMedicare PIN
FLE8128WMedicare PIN