Provider Demographics
NPI:1578689345
Name:BENJAMIN, PHILIP (DC)
Entity Type:Individual
Prefix:DR
First Name:PHILIP
Middle Name:
Last Name:BENJAMIN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20780 NE 31ST PL
Mailing Address - Street 2:
Mailing Address - City:AVENTURA
Mailing Address - State:FL
Mailing Address - Zip Code:33180-3607
Mailing Address - Country:US
Mailing Address - Phone:305-931-7788
Mailing Address - Fax:
Practice Address - Street 1:20780 NE 31ST PL
Practice Address - Street 2:
Practice Address - City:AVENTURA
Practice Address - State:FL
Practice Address - Zip Code:33180-3607
Practice Address - Country:US
Practice Address - Phone:305-931-7788
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH0003689111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor