Healthcare Provider Details

I. General information

NPI: 1427234103
Provider Name (Legal Business Name): JASON BENEDICT BUENAVENTURA D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/13/2008
Last Update Date: 03/25/2025
Certification Date: 03/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 MUNRO AVE
CAPE MAY NJ
08204-5000
US

IV. Provider business mailing address

1 MUNRO AVE
CAPE MAY NJ
08204-5000
US

V. Phone/Fax

Practice location:
  • Phone: 609-898-6610
  • Fax: 609-898-6962
Mailing address:
  • Phone: 609-898-6610
  • Fax: 609-898-6962

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number02003292A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: