Healthcare Provider Details

I. General information

NPI: 1417970377
Provider Name (Legal Business Name): BENNY ESQUENAZI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/25/2006
Last Update Date: 05/16/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10067 PINES BLVD B
PEMBROKE PINES FL
33024-6136
US

IV. Provider business mailing address

10067 PINES BLVD B
PEMBROKE PINES FL
33024-6136
US

V. Phone/Fax

Practice location:
  • Phone: 954-430-7777
  • Fax: 954-430-3667
Mailing address:
  • Phone: 954-430-7777
  • Fax: 954-430-3667

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberME96081
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: