MEDICARE: SPENCER BENAYOUN APRN, FNP-BC

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	163W00000X	Registered Nurse	9568253	FL
2	363LF0000X	Family Nurse Practitioner	11041446	FL

General Provider Information

NPI Number	:	1972398972
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SPENCER BENAYOUN APRN, FNP-BC

Provider Business Mailing Address
First Line	:	3101 S OCEAN DR APT 1405
Second Line	:
City	:	HOLLYWOOD
State	:	FL
Zip	:	33019-2835
Country	:	US
Telephone Number	:	847-644-9018
Fax Number	:

Provider Business Practice Location Address
First Line	:	3101 S OCEAN DR APT 1405
Second Line	:
City	:	HOLLYWOOD
State	:	FL
Zip	:	33019-2835
Country	:	US
Telephone Number	:	847-644-9018
Fax Number	:

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

Provider Enumeration Date	:	04/10/2025
Last Update Date	:	05/04/2026

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