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General NPI Number Information
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NPI Number | 1770177446
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Entity Type | Individual
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Provider Name | PATRICK MITCHEL BENGSTON APRN
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Gender | Male
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Dates
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Enumeration Date | 02/23/2021
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Last Update Date | 04/01/2025
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Provider Practice Location Address
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Address Line | 8924 ARABELLA LN
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City | SEMINOLE
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State | FL
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Zip | 33777-2649
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Country | US
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Telephone | 800-991-7630
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Fax | 800-921-1799
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Provider Business Mailing Address
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Address Line | 15500 ROOSEVELT BLVD
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City | CLEARWATER
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State | FL
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Zip | 33760-3430
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Country | US
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Telephone | 727-310-0831
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Fax | 727-222-5950
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | APRN11011952
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License Number State | FL
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