Healthcare Provider Details

I. General information

NPI: 1376341792
Provider Name (Legal Business Name): ELIZABETH JULIA BENNETTT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ELIZABETH JULIA OCCHINO

II. Dates (important events)

Enumeration Date: 03/03/2025
Last Update Date: 07/11/2025
Certification Date: 07/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2600 BRUCE B DOWNS BLVD
WESLEY CHAPEL FL
33544-9207
US

IV. Provider business mailing address

1360 VIRGINIA LEE CIR
BROOKSVILLE FL
34602-6243
US

V. Phone/Fax

Practice location:
  • Phone: 813-929-5000
  • Fax:
Mailing address:
  • Phone: 910-584-8500
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberRN9462101
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberAPRN11040192
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: