MEDICARE: MS. CLARE DENISE BENJAMIN ARNP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor	MH 5684	FL
2	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	ARNP 1128632	FL

General Provider Information

NPI Number	:	1003097213
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. CLARE DENISE BENJAMIN ARNP

Provider Business Mailing Address
First Line	:	12058 SAN JOSE BLVD STE 802
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32223-8667
Country	:	US
Telephone Number	:	904-910-9060
Fax Number	:	904-372-6087

Provider Business Practice Location Address
First Line	:	12058 SAN JOSE BLVD STE 802
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32223-8667
Country	:	US
Telephone Number	:	904-910-9060
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/15/2007
Last Update Date	:	07/22/2021

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