Provider Demographics
NPI:1407840622
Name:BENTZE, MICHAEL JAMES (DO)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:JAMES
Last Name:BENTZE
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:11715 RANGELAND PKWY
Mailing Address - Street 2:
Mailing Address - City:BRADENTON
Mailing Address - State:FL
Mailing Address - Zip Code:34211-9529
Mailing Address - Country:US
Mailing Address - Phone:941-538-0001
Mailing Address - Fax:941-958-0002
Practice Address - Street 1:11715 RANGELAND PKWY
Practice Address - Street 2:
Practice Address - City:BRADENTON
Practice Address - State:FL
Practice Address - Zip Code:34211-9529
Practice Address - Country:US
Practice Address - Phone:941-538-0001
Practice Address - Fax:941-538-0002
Is Sole Proprietor?:No
Enumeration Date:2005-09-02
Last Update Date:2023-11-09
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
FLOS9174207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL270745400Medicaid
FL48291OtherBCBS
FL48291ZMedicare PIN
FL270745400Medicaid