Provider Demographics
NPI:1467998328
Name:BENOIT, ADILNA I
Entity Type:Individual
Prefix:
First Name:ADILNA
Middle Name:
Last Name:BENOIT
Suffix:I
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6301 LAKE WESTON POINT LN APT 926
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32810-4478
Mailing Address - Country:US
Mailing Address - Phone:407-285-0172
Mailing Address - Fax:
Practice Address - Street 1:6301 LAKE WESTON POINT LN APT 926
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32810-4478
Practice Address - Country:US
Practice Address - Phone:407-285-0172
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-01-16
Last Update Date:2017-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPTA27308225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant