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NPI Code Detail

MEDICARE: ROBERT BENISH M.D.

MEDICARE: ROBERT BENISH 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
1208M00000XHospitalist PhysicianME139365FL
2207RG0100XGastroenterology PhysicianME139365FL

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2KV241OTHERFLMEDICARE

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 : 1750342747
Entity Type Code : Individual
Provider Name (Legal Business Name) : ROBERT BENISH M.D.
Provider Business Mailing Address
First Line : 3300 S FISKE BLVD
Second Line :
City : ROCKLEDGE
State : FL
Zip : 32955-4306
Country : US
Telephone Number : 321-434-8078
Fax Number : 321-951-7408
Provider Business Practice Location Address
First Line : 1425 MALABAR RD NE
Second Line :
City : PALM BAY
State : FL
Zip : 32907-2506
Country : US
Telephone Number : 321-434-8420
Fax Number : 321-434-8148
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/29/2006
Last Update Date : 07/11/2019

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