Provider Demographics
NPI:1003097213
Name:BENJAMIN, CLARE DENISE (ARNP)
Entity Type:Individual
Prefix:MS
First Name:CLARE
Middle Name:DENISE
Last Name:BENJAMIN
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12058 SAN JOSE BLVD STE 802
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32223-8667
Mailing Address - Country:US
Mailing Address - Phone:904-910-9060
Mailing Address - Fax:904-372-6087
Practice Address - Street 1:12058 SAN JOSE BLVD STE 802
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32223-8667
Practice Address - Country:US
Practice Address - Phone:904-910-9060
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-11-15
Last Update Date:2021-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH 5684101YM0800X
FLARNP 1128632363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health