Provider Demographics
NPI:1326593146
Name:BENOIT, CHARLENET
Entity Type:Individual
Prefix:
First Name:CHARLENET
Middle Name:
Last Name:BENOIT
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1298 NW 15TH AVE APT A
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33486-2028
Mailing Address - Country:US
Mailing Address - Phone:561-584-4339
Mailing Address - Fax:
Practice Address - Street 1:1298 NW 15TH AVE APT A
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33486-2028
Practice Address - Country:US
Practice Address - Phone:561-584-4339
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-08-22
Last Update Date:2016-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPTA26936225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant