Provider Demographics
NPI:1548386394
Name:STOREY, BENJAMIN BARCKLEY JR (MD)
Entity Type:Individual
Prefix:
First Name:BENJAMIN
Middle Name:BARCKLEY
Last Name:STOREY
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:8340 COLLIER BLVD STE 400
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34114-3626
Mailing Address - Country:US
Mailing Address - Phone:239-348-4221
Mailing Address - Fax:239-732-1732
Practice Address - Street 1:8340 COLLIER BLVD
Practice Address - Street 2:#400
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34114
Practice Address - Country:US
Practice Address - Phone:239-333-3200
Practice Address - Fax:239-992-5785
Is Sole Proprietor?:No
Enumeration Date:2007-03-22
Last Update Date:2020-09-01
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME115025208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL1193474OtherWELLCARE
FLP01213517OtherRR MEDICARE
FLP1010667OtherFREEDOM HEALTH
FL009559200Medicaid
FL9563127OtherCIGNA
FLP01213517OtherRAILROAD MCR
FL367681OtherAVMED
FL14R8ZOtherBCBS OF FL
FL9760983OtherAETNA
FLP01807771OtherCLEAR HEALTH ALLIANCE
FLP01213517OtherRR MEDICARE