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General NPI Number Information
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NPI Number | 1700074267
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Entity Type | Organization
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Legal Business Name | CAREN J BENNETT MD PA
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Dates
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Enumeration Date | 10/10/2007
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Last Update Date | 10/10/2007
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Provider Practice Location Address
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Address Line | 3157 N UNIVERSITY DR SUITE 101
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City | PEMBROKE PINES
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State | FL
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Zip | 33024-2258
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Country | US
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Telephone | 954-441-6226
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Fax | 954-443-3994
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Provider Business Mailing Address
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Address Line | 3157 N UNIVERSITY DR SUITE 101
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City | PEMBROKE PINES
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State | FL
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Zip | 33024-2258
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Country | US
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Telephone | 954-441-6226
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Fax | 954-443-3994
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Authorized Official
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Title or Position | OWNER
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Name | MRS. CAREN JILL BENNETT
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Credential | MD
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Telephone | 954-441-6226
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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 | ME63266
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License Number State | FL
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