MEDICARE: DR. CHRISTOPHER B BENTON 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	174400000X	Specialist	9668	NH
2	2084P0800X	Psychiatry Physician	ME122053	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
2	0108431YONH02	OTHER	NH	BC/BS - BILLING

General Provider Information

NPI Number	:	1356338784
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CHRISTOPHER B BENTON M.D.

Provider Business Mailing Address
First Line	:	1695 NW 9TH AVE
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33136-1409
Country	:	US
Telephone Number	:	305-355-7777
Fax Number	:	305-355-9201

Provider Business Practice Location Address
First Line	:	1695 NW 9TH AVE
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33136-1409
Country	:	US
Telephone Number	:	305-355-7777
Fax Number	:	305-355-9201

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

Provider Enumeration Date	:	09/30/2005
Last Update Date	:	03/20/2015

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