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NPI Code Detail

MEDICARE: DR. JOHN GORDON BENNETT MD

MEDICARE:  DR. JOHN GORDON BENNETT  MD
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
1172V00000XCommunity Health Worker48950FL

General Provider Information

NPI Number : 1548598410
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JOHN GORDON BENNETT MD
Provider Business Mailing Address
First Line : 1200 WEST AVE
Second Line : SUITE 825
City : MIAMI BEACH
State : FL
Zip : 33139
Country : US
Telephone Number : 786-370-3917
Fax Number :
Provider Business Practice Location Address
First Line : 1200 WEST AVE
Second Line : SUITE 825
City : MIAMI BEACH
State : FL
Zip : 33139-4377
Country : US
Telephone Number : 786-370-3917
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/03/2009
Last Update Date : 04/26/2012

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Directions to “ DR. JOHN GORDON BENNETT MD” Practice Location

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