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General NPI Number Information
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NPI Number | 1114805165
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Entity Type | Organization
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Legal Business Name | BENJAMIN COMMUNITY HEALTH CENTER INC
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Dates
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Enumeration Date | 08/26/2025
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Last Update Date | 08/29/2025
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Provider Practice Location Address
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Address Line | 3939 HOLLYWOOD BLVD STE 1B
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City | HOLLYWOOD
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State | FL
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Zip | 33021-6749
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Country | US
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Telephone | 954-251-0267
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Fax | 954-239-7987
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Provider Business Mailing Address
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Address Line | 3939 HOLLYWOOD BLVD STE 1B
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City | HOLLYWOOD
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State | FL
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Zip | 33021-6749
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Country | US
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Telephone | 954-251-0267
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Fax | 954-239-7987
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | ILNISE MATHIEU
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Credential |
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Telephone | 954-251-0267
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QC1500X
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Taxonomy Name | Community Health Clinic/Center
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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