MEDICARE: PEGGY BENZING 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
1	207P00000X	Emergency Medicine Physician	OS5456	FL
2	207Q00000X	Family Medicine Physician	OS55456	FL

General Provider Information

NPI Number	:	1699727743
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PEGGY BENZING D.O.

Provider Business Mailing Address
First Line	:	1605 MANOR RD
Second Line	:
City	:	ENGLEWOOD
State	:	FL
Zip	:	34223-4929
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	8431 POINTE LOOP DR
Second Line	:	FIRST FLOOR
City	:	VENICE
State	:	FL
Zip	:	34293-2232
Country	:	US
Telephone Number	:	941-207-5320
Fax Number	:	941-207-5321

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

Provider Enumeration Date	:	05/17/2006
Last Update Date	:	12/01/2016

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Directions to “ PEGGY BENZING D.O.” Practice Location

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