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General NPI Number Information
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NPI Number | 1093988719
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Entity Type | Organization
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Legal Business Name | SOUTH FLORIDA KIDNEY ASSOCIATES PA
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Dates
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Enumeration Date | 04/03/2008
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Last Update Date | 04/09/2008
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Provider Practice Location Address
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Address Line | 17913 NW 7TH ST STE 104
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City | PEMBROKE PINES
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State | FL
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Zip | 33029-2811
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Country | US
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Telephone | 954-885-1024
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Fax | 954-885-1340
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Provider Business Mailing Address
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Address Line | 17913 NW 7TH ST STE 104
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City | PEMBROKE PINES
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State | FL
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Zip | 33029-2811
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Country | US
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Telephone | 954-885-1024
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Fax | 954-885-1340
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Authorized Official
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Title or Position | OWNER
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Name | DR. MAX F BENJAMIN
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Credential | MD
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Telephone | 954-885-1024
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | ME57110
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License Number State | FL
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