Healthcare Provider Details

I. General information

NPI: 1265437313
Provider Name (Legal Business Name): ROBERT S. BENINTENDI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/16/2005
Last Update Date: 08/09/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2055 HOSPITAL DRIVE SUITE 130
BATAVIA OH
45103-9518
US

IV. Provider business mailing address

5400 DUPONT CIRCLE SUITE A
MILFORD OH
45150
US

V. Phone/Fax

Practice location:
  • Phone: 513-732-0870
  • Fax: 513-732-0873
Mailing address:
  • Phone: 513-576-7700
  • Fax: 513-576-1020

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number35024889
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: