Provider Demographics
NPI:1710324546
Name:BENJAMIN, BESSY WILSON (CRNA)
Entity Type:Individual
Prefix:
First Name:BESSY
Middle Name:WILSON
Last Name:BENJAMIN
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:470 8TH ST SE
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34117-9351
Mailing Address - Country:US
Mailing Address - Phone:954-812-4250
Mailing Address - Fax:
Practice Address - Street 1:1 TAMPA GENERAL CIRCLE, SUITE A327
Practice Address - Street 2:FLORIDA GULF TO BAY ANESTHESIOLOGY ASSOCIATES, LLC
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33606
Practice Address - Country:US
Practice Address - Phone:954-812-4250
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-03
Last Update Date:2013-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9265820367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered