Provider Demographics
NPI:1043376890
Name:EPSTEIN, BENJAMIN CHARLES (DO, MA)
Entity Type:Individual
Prefix:
First Name:BENJAMIN
Middle Name:CHARLES
Last Name:EPSTEIN
Suffix:
Gender:M
Credentials:DO, MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1924 US HIGHWAY 441 N
Mailing Address - Street 2:
Mailing Address - City:OKEECHOBEE
Mailing Address - State:FL
Mailing Address - Zip Code:34972-1922
Mailing Address - Country:US
Mailing Address - Phone:863-357-0540
Mailing Address - Fax:863-357-0546
Practice Address - Street 1:1924 US HIGHWAY 441 N
Practice Address - Street 2:
Practice Address - City:OKEECHOBEE
Practice Address - State:FL
Practice Address - Zip Code:34972-1922
Practice Address - Country:US
Practice Address - Phone:863-357-0540
Practice Address - Fax:863-357-0546
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-28
Last Update Date:2012-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS10817207XS0114X, 207XX0005X, 207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
No207XS0114XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryAdult Reconstructive Orthopaedic Surgery
No207XX0005XAllopathic & Osteopathic PhysiciansOrthopaedic SurgerySports Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ52280000Medicaid
FL001728600Medicaid
FLCT684ZMedicare PIN
FLF37317Medicare UPIN
NJ101446Medicare ID - Type Unspecified
FL001728600Medicaid