MEDICARE: MS. KATHLEEN ANNE BENOIT NP

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	363L00000X	Nurse Practitioner	11012245	FL

General Provider Information

NPI Number	:	1912214800
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. KATHLEEN ANNE BENOIT NP

Provider Business Mailing Address
First Line	:	3211 JOG PARK DR
Second Line	:
City	:	GREENACRES
State	:	FL
Zip	:	33467-2015
Country	:	US
Telephone Number	:	401-500-3758
Fax Number	:

Provider Business Practice Location Address
First Line	:	3211 JOG PARK DR
Second Line	:
City	:	GREENACRES
State	:	FL
Zip	:	33467-2015
Country	:	US
Telephone Number	:	401-500-3758
Fax Number	:

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

Provider Enumeration Date	:	09/13/2010
Last Update Date	:	01/07/2026

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