Healthcare Provider Details

I. General information

NPI: 1134697592
Provider Name (Legal Business Name): ALICIA BENJAMIN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/05/2018
Last Update Date: 09/01/2026
Certification Date: 09/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9401 SW HIGHWAY 200 BLDG 200
OCALA FL
34481-9612
US

IV. Provider business mailing address

9401 SOUTHWEST STATE ROAD 200 BUILDING 200
OCALA FL
34481
US

V. Phone/Fax

Practice location:
  • Phone: 352-401-8660
  • Fax: 352-732-6787
Mailing address:
  • Phone: 352-401-8660
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberME156296
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: