MEDICARE: BENJAMIN SOARES

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	390200000X	Student in an Organized Health Care Education/Training Program

General Provider Information

NPI Number	:	1841132875
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BENJAMIN SOARES

Provider Business Mailing Address
First Line	:	19 WINCHESTER ST APT 401
Second Line	:
City	:	BROOKLINE
State	:	MA
Zip	:	02446-2741
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	115 LINCOLN ST
Second Line	:
City	:	FRAMINGHAM
State	:	MA
Zip	:	01702-6358
Country	:	US
Telephone Number	:	508-383-1000
Fax Number	:

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

Provider Enumeration Date	:	04/08/2026
Last Update Date	:	05/12/2026

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