Healthcare Provider Details

I. General information

NPI: 1518949502
Provider Name (Legal Business Name): SUSAN BARBARA BENHAIM MD
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 11/16/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2345 W HILLSBORO BLVD SUITE 201
DEERFIELD BEACH FL
33442
US

IV. Provider business mailing address

2345 W HILLSBORO BLVD SUITE 201
DEERFIELD BEACH FL
33442
US

V. Phone/Fax

Practice location:
  • Phone: 954-427-4966
  • Fax: 954-427-6517
Mailing address:
  • Phone: 954-427-4966
  • Fax: 954-427-6517

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberME86835
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: