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NPI Code Detail

MEDICARE: DR. ALYN L BENEZETTE D.O.

MEDICARE:  DR. ALYN L BENEZETTE  D.O.
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
12084N0400XNeurology PhysicianOS5774FL

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 : 1508863572
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ALYN L BENEZETTE D.O.
Provider Business Mailing Address
First Line : 725 W GRANADA BLVD
Second Line : SUITE 22
City : ORMOND BEACH
State : FL
Zip : 32174-9406
Country : US
Telephone Number : 386-788-2300
Fax Number : 386-944-6622
Provider Business Practice Location Address
First Line : 725 W GRANADA BLVD
Second Line : SUITE 22
City : ORMOND BEACH
State : FL
Zip : 32174-9406
Country : US
Telephone Number : 386-788-2300
Fax Number : 386-944-6622
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/05/2005
Last Update Date : 06/16/2025

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Directions to “ DR. ALYN L BENEZETTE D.O.” Practice Location

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