Provider Demographics
NPI:1023558228
Name:DEBSKI, BENJAMIN A (APRN)
Entity Type:Individual
Prefix:
First Name:BENJAMIN
Middle Name:A
Last Name:DEBSKI
Suffix:
Gender:M
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3176 SOUTHERN OAKS DR
Mailing Address - Street 2:
Mailing Address - City:GREEN COVE SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:32043-9454
Mailing Address - Country:US
Mailing Address - Phone:321-501-0611
Mailing Address - Fax:
Practice Address - Street 1:1996 KINGSLEY AVE
Practice Address - Street 2:
Practice Address - City:ORANGE PARK
Practice Address - State:FL
Practice Address - Zip Code:32073-4442
Practice Address - Country:US
Practice Address - Phone:904-276-5700
Practice Address - Fax:904-272-1474
Is Sole Proprietor?:No
Enumeration Date:2017-03-07
Last Update Date:2020-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9369127363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily