MEDICARE: MR. JEAN E. BENJAMIN RRT

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	2279C0205X	Critical Care Registered Respiratory Therapist	RT5605	FL
2	2279G1100X	General Care Registered Respiratory Therapist	RT5605	FL
3	2279H0200X	Home Health Registered Respiratory Therapist	RT5605	FL

General Provider Information

NPI Number	:	1528240793
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. JEAN E. BENJAMIN RRT

Provider Business Mailing Address
First Line	:	305 NE 151ST ST
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33162-5011
Country	:	US
Telephone Number	:	305-940-2654
Fax Number	:	305-944-4038

Provider Business Practice Location Address
First Line	:	305 NE 151ST ST
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33162-5011
Country	:	US
Telephone Number	:	305-940-2654
Fax Number	:	305-944-4038

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

Provider Enumeration Date	:	11/29/2007
Last Update Date	:	11/29/2007

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