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NPI Code Detail

MEDICARE: BENJAMIN S MCKENDALL MD

MEDICARE: BENJAMIN S MCKENDALL MD
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
1207W00000XOphthalmology PhysicianME0027026FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1023164399
Entity Type Code : Individual
Provider Name (Legal Business Name) : BENJAMIN S MCKENDALL MD
Provider Business Mailing Address
First Line : 2435 S VOLUSIA AVE
Second Line : SUITE D-1
City : ORANGE CITY
State : FL
Zip : 32763-7643
Country : US
Telephone Number : 386-775-7733
Fax Number :
Provider Business Practice Location Address
First Line : 2435 S VOLUSIA AVE
Second Line : SUITE D-1
City : ORANGE CITY
State : FL
Zip : 32763-7643
Country : US
Telephone Number : 386-775-7733
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/26/2007
Last Update Date : 12/10/2008

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