Healthcare Provider Details

I. General information

NPI: 1023993821
Provider Name (Legal Business Name): BENJAMIN N ISRAEL PHD,DN,NP
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/11/2025
Last Update Date: 03/28/2026
Certification Date: 03/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13194 US 301 S # 212
RIVERVIEW FL
33578-7410
US

IV. Provider business mailing address

13194 US 301 S # 212
RIVERVIEW FL
33578-7410
US

V. Phone/Fax

Practice location:
  • Phone: 727-685-7301
  • Fax:
Mailing address:
  • Phone: 727-685-7301
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number7101739
License Number StateIN
# 2
Primary TaxonomyN
Taxonomy Code172P00000X
TaxonomyNaprapath
License Number0000000345
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code172P00000X
TaxonomyNaprapath
License Number
License Number StateIL
# 4
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number0000000000
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: