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General NPI Number Information
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NPI Number | 1821894536
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Entity Type | Individual
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Provider Name | GINA MARIE BENENATI APRN, AGACNP-BC
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Gender | Female
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Dates
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Enumeration Date | 02/22/2025
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Last Update Date | 02/22/2025
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Provider Practice Location Address
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Address Line | 1900 NEBRASKA AVE STE 9
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City | FORT PIERCE
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State | FL
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Zip | 34950-4837
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Country | US
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Telephone | 772-465-4499
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Fax |
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Provider Business Mailing Address
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Address Line | 14326 SW SOLANGE ST
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City | PORT ST LUCIE
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State | FL
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Zip | 34987-5845
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Country | US
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Telephone | 631-624-5261
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Fax |
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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 | 363LA2100X
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Taxonomy Name | Acute Care Nurse Practitioner
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License Number | 11037797
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License Number State | FL
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