Provider Demographics
NPI:1033312335
Name:BENSON, REGINA PAULINE (DO)
Entity Type:Individual
Prefix:DR
First Name:REGINA
Middle Name:PAULINE
Last Name:BENSON
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:REGINA
Other - Middle Name:PAULINE
Other - Last Name:BLAKLEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4131 NW 13TH STREET
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32609-4151
Mailing Address - Country:US
Mailing Address - Phone:352-376-1887
Mailing Address - Fax:
Practice Address - Street 1:6500 WEST NEWBERRY RD
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32605-4309
Practice Address - Country:US
Practice Address - Phone:352-333-4180
Practice Address - Fax:352-333-4861
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-06
Last Update Date:2011-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS10406207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology