Provider Demographics
NPI:1891023362
Name:BENYA, DONNA KAY (PA-C)
Entity Type:Individual
Prefix:
First Name:DONNA
Middle Name:KAY
Last Name:BENYA
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2440 SE FEDERAL HWY
Mailing Address - Street 2:
Mailing Address - City:STUART
Mailing Address - State:FL
Mailing Address - Zip Code:34994-4531
Mailing Address - Country:US
Mailing Address - Phone:772-784-2207
Mailing Address - Fax:888-831-3522
Practice Address - Street 1:18941 SE CASTLE RD
Practice Address - Street 2:
Practice Address - City:JUPITER
Practice Address - State:FL
Practice Address - Zip Code:33458-1048
Practice Address - Country:US
Practice Address - Phone:561-323-7609
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-11-21
Last Update Date:2019-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME91258207R00000X
FL9105966363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine