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General NPI Number Information
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NPI Number | 1285709436
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Entity Type | Organization
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Legal Business Name | RICARDO M. BENNETT DPM
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Dates
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Enumeration Date | 11/22/2006
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Last Update Date | 04/20/2008
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Provider Practice Location Address
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Address Line | 5275 LEE HWY SUITE 303
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City | ARLINGTON
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State | VA
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Zip | 22207-1619
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Country | US
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Telephone | 703-538-5111
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Fax | 703-538-4193
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Provider Business Mailing Address
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Address Line | 5275 LEE HWY SUITE 303
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City | ARLINGTON
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State | VA
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Zip | 22207-1619
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Country | US
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Telephone | 703-538-5111
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Fax | 703-538-4193
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Authorized Official
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Title or Position | DOCTOR
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Name | RICARDO BENNETT
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Credential | D.P.M.
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Telephone | 703-538-5111
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213E00000X
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Taxonomy Name | Podiatrist
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License Number |
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License Number State | VA
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