Provider Demographics
NPI:1093900557
Name:BENJAMIN, RONALD F (DO)
Entity Type:Individual
Prefix:
First Name:RONALD
Middle Name:F
Last Name:BENJAMIN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5850 SE 5TH ST
Mailing Address - Street 2:SUITE 101
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34472-1201
Mailing Address - Country:US
Mailing Address - Phone:352-624-3500
Mailing Address - Fax:352-624-3055
Practice Address - Street 1:5850 SE 5TH ST
Practice Address - Street 2:SUITE 101
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34472-1201
Practice Address - Country:US
Practice Address - Phone:352-624-3500
Practice Address - Fax:352-624-3055
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-07
Last Update Date:2007-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS7252207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
K9093Medicare PIN
G45613Medicare UPIN