Healthcare Provider Details

I. General information

NPI: 1265295083
Provider Name (Legal Business Name): BENSADON MEDICAL PSYCHOLOGY & GERIATRICS PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/05/2024
Last Update Date: 02/05/2024
Certification Date: 02/04/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

150 E PALMETTO PARK RD STE 800
BOCA RATON FL
33432-4833
US

IV. Provider business mailing address

150 E PALMETTO PARK RD STE 800
BOCA RATON FL
33432-4833
US

V. Phone/Fax

Practice location:
  • Phone: 561-465-7557
  • Fax:
Mailing address:
  • Phone: 561-465-7557
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: DR. BENJAMIN A BENSADON
Title or Position: PRESIDENT
Credential: EDM, PHD
Phone: 561-465-7557