Provider Demographics
NPI:1093776411
Name:BENNETT, NORMAN E (MD)
Entity Type:Individual
Prefix:DR
First Name:NORMAN
Middle Name:E
Last Name:BENNETT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:1001 SE MONTEREY COMMONS BLVD
Mailing Address - Street 2:SUITE 300
Mailing Address - City:STUART
Mailing Address - State:FL
Mailing Address - Zip Code:34996-3329
Mailing Address - Country:US
Mailing Address - Phone:772-286-9400
Mailing Address - Fax:772-283-3832
Practice Address - Street 1:1001 SE MONTEREY COMMONS BLVD
Practice Address - Street 2:SUITE 300
Practice Address - City:STUART
Practice Address - State:FL
Practice Address - Zip Code:34996-3329
Practice Address - Country:US
Practice Address - Phone:772-286-9400
Practice Address - Fax:772-283-3832
Is Sole Proprietor?:No
Enumeration Date:2006-03-28
Last Update Date:2023-06-01
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME78723207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL260190700Medicaid
FL47087ZMedicare ID - Type Unspecified
FL260190700Medicaid