MEDICARE: MICHELENE BENOIT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	374U00000X	Home Health Aide		FL
2	376K00000X	Nurse's Aide	9301849	PA
3	390200000X	Student in an Organized Health Care Education/Training Program
4	390200000X	Student in an Organized Health Care Education/Training Program		PA
5	376K00000X	Nurse's Aide	CNA175604	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	352526795	OTHER	FL	NURSE REGISTRY
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1225485931
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHELENE BENOIT

Provider Business Mailing Address
First Line	:	2014 E CHELTEN AVE
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19138-3014
Country	:	US
Telephone Number	:	267-730-7990
Fax Number	:	215-438-8850

Provider Business Practice Location Address
First Line	:	2014 E CHELTEN AVE
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19138-3014
Country	:	US
Telephone Number	:	267-730-7990
Fax Number	:	215-438-8850

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/23/2016
Last Update Date	:	12/05/2020

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Directions to “ MICHELENE BENOIT ” Practice Location

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