Provider Demographics
NPI:1710361134
Name:BENSADON, BENJAMIN ANDRE (PHD)
Entity Type:Individual
Prefix:DR
First Name:BENJAMIN
Middle Name:ANDRE
Last Name:BENSADON
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1015 SPANISH RIVER RD
Mailing Address - Street 2:APT 309
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33432-7610
Mailing Address - Country:US
Mailing Address - Phone:561-297-2578
Mailing Address - Fax:
Practice Address - Street 1:1015 SPANISH RIVER RD
Practice Address - Street 2:APT 309
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33432
Practice Address - Country:US
Practice Address - Phone:917-533-4095
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-15
Last Update Date:2017-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY 9280103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical