Provider Demographics
NPI:1831661669
Name:BENOIT, JUNIE
Entity Type:Individual
Prefix:
First Name:JUNIE
Middle Name:
Last Name:BENOIT
Suffix:
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 1:205 BRECKENRIDGE CIR SE
Mailing Address - Street 2:
Mailing Address - City:PALM BAY
Mailing Address - State:FL
Mailing Address - Zip Code:32909-2337
Mailing Address - Country:US
Mailing Address - Phone:321-432-1002
Mailing Address - Fax:
Practice Address - Street 1:205 BRECKENRIDGE CIR SE
Practice Address - Street 2:
Practice Address - City:PALM BAY
Practice Address - State:FL
Practice Address - Zip Code:32909-2337
Practice Address - Country:US
Practice Address - Phone:321-432-1002
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-12-18
Last Update Date:2018-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant