MEDICARE: SOPHIA ALESANDRA BENIGNO

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	163WC0200X	Critical Care Medicine Registered Nurse	24174169	MO

General Provider Information

NPI Number	:	1063376713
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SOPHIA ALESANDRA BENIGNO

Provider Business Mailing Address
First Line	:	601 PADDINGTON HILL DR
Second Line	:
City	:	CHESTERFIELD
State	:	MO
Zip	:	63017-2166
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1 BARNES JEWISH HOSPITAL PLZ
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63110-1003
Country	:	US
Telephone Number	:	314-747-3000
Fax Number	:

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

Provider Enumeration Date	:	12/16/2025
Last Update Date	:	12/16/2025

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