MEDICARE: ALLEN H BEZNER MD PA

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	174400000X	Specialist	ME38678	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	02977	OTHER	FL	WELLCARE/HEALTHEASE
2	5945	OTHER	FL	NEIGHBORHOOD HEALTH PLAN
3	1003492	OTHER	FL	CAREPLUS
4	071095	OTHER	FL	AV MED
5	4099722	OTHER	FL	AETNA

General Provider Information

NPI Number	:	1407943426
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ALLEN H BEZNER MD PA

Provider Business Mailing Address
First Line	:	116 JFK DR
Second Line	:	BLDG 110
City	:	ATLANTIS
State	:	FL
Zip	:	33462-6606
Country	:	US
Telephone Number	:	561-439-1234
Fax Number	:	561-439-0506

Provider Business Practice Location Address
First Line	:	116 JFK DR
Second Line	:	BLDG 110
City	:	ATLANTIS
State	:	FL
Zip	:	33462-6606
Country	:	US
Telephone Number	:	561-439-1234
Fax Number	:	561-439-0506

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. ALLEN H BEZNER
Credential	:	M.D.
Telephone Number	:	561-439-1234

Provider Enumeration Date	:	10/10/2006
Last Update Date	:	08/22/2020

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