Provider Demographics
NPI:1396635462
Name:DRISKELL, BENI W (LMT)
Entity type:Individual
Prefix:MR
First Name:BENI
Middle Name:W
Last Name:DRISKELL
Suffix:
Gender:M
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3851 ADAMS RD
Mailing Address - Street 2:
Mailing Address - City:MILTON
Mailing Address - State:FL
Mailing Address - Zip Code:32571-9326
Mailing Address - Country:US
Mailing Address - Phone:850-463-6033
Mailing Address - Fax:
Practice Address - Street 1:5599 STEWART ST
Practice Address - Street 2:
Practice Address - City:MILTON
Practice Address - State:FL
Practice Address - Zip Code:32570-4344
Practice Address - Country:US
Practice Address - Phone:540-226-9454
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-08
Last Update Date:2025-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMA94561225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist