MEDICARE: DR. PAUL XAVIER BENEDETTO M.D.

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	207ND0101X	MOHS-Micrographic Surgery Physician	ME143368	FL

Other Identifiers

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

General Provider Information

NPI Number	:	1134393028
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. PAUL XAVIER BENEDETTO M.D.

Provider Business Mailing Address
First Line	:	2221 GARRETT RD
Second Line	:
City	:	DREXEL HILL
State	:	PA
Zip	:	19026-1101
Country	:	US
Telephone Number	:	610-623-5885
Fax Number	:

Provider Business Practice Location Address
First Line	:	5701 N. UNIVERSITY DR.
Second Line	:
City	:	CORAL SPRINGS
State	:	FL
Zip	:	33067
Country	:	US
Telephone Number	:	954-659-5264
Fax Number	:	954-659-5260

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

Provider Enumeration Date	:	04/22/2008
Last Update Date	:	05/03/2024

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