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NPI Code Detail

MEDICARE: MS. DORIS BENREY-BOGUSLAVSKY

MEDICARE: MS. DORIS BENREY-BOGUSLAVSKY
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
1101YM0800XMental Health CounselorIMH21526FL
2222Q00000XDevelopmental Therapist

General Provider Information

NPI Number : 1992477731
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. DORIS BENREY-BOGUSLAVSKY
Provider Business Mailing Address
First Line : 10752 DEERWOOD PARK BLVD
Second Line :
City : JACKSONVILLE
State : FL
Zip : 32256-4849
Country : US
Telephone Number : 904-618-1847
Fax Number : 904-621-9339
Provider Business Practice Location Address
First Line : 10752 DEERWOOD PARK BLVD
Second Line :
City : JACKSONVILLE
State : FL
Zip : 32256-4849
Country : US
Telephone Number : 904-618-1847
Fax Number : 904-621-9339
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/30/2021
Last Update Date : 06/01/2026

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Directions to “ MS. DORIS BENREY-BOGUSLAVSKY ” Practice Location

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