MEDICARE: MR. BENJAMIN HOWARD MEYER PTA

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	208100000X	Physical Medicine & Rehabilitation Physician	PTA24944	FL

General Provider Information

NPI Number	:	1730708389
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. BENJAMIN HOWARD MEYER PTA

Provider Business Mailing Address
First Line	:	1227 SE 23RD PL APT 1
Second Line	:
City	:	CAPE CORAL
State	:	FL
Zip	:	33990-6902
Country	:	US
Telephone Number	:	239-699-9018
Fax Number	:

Provider Business Practice Location Address
First Line	:	1227 SE 23RD PL APT 1
Second Line	:
City	:	CAPE CORAL
State	:	FL
Zip	:	33990-6902
Country	:	US
Telephone Number	:	239-699-9018
Fax Number	:

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

Provider Enumeration Date	:	04/14/2020
Last Update Date	:	04/14/2020

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