Provider Demographics
NPI:1962461806
Name:BENCHIMOL, GEORGE M (MD)
Entity Type:Individual
Prefix:
First Name:GEORGE
Middle Name:M
Last Name:BENCHIMOL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6900 NW 9TH BLVD
Mailing Address - Street 2:SUITE B
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32605-4251
Mailing Address - Country:US
Mailing Address - Phone:352-333-6680
Mailing Address - Fax:352-331-4006
Practice Address - Street 1:6900 NW 9TH BLVD
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32605-4251
Practice Address - Country:US
Practice Address - Phone:352-333-6680
Practice Address - Fax:352-331-4006
Is Sole Proprietor?:No
Enumeration Date:2006-03-20
Last Update Date:2022-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME44625207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL047806700Medicaid
FL01396ZMedicare ID - Type UnspecifiedMEDICARE
FLP00723110Medicare PIN
FL047806700Medicaid
FL01396YMedicare PIN