Provider Demographics
NPI:1982654703
Name:BENSON, LLOYD LYNN (RPT)
Entity Type:Individual
Prefix:MR
First Name:LLOYD
Middle Name:LYNN
Last Name:BENSON
Suffix:
Gender:M
Credentials:RPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3750 EMERGENCY LN
Mailing Address - Street 2:SUITE 2
Mailing Address - City:SEBRING
Mailing Address - State:FL
Mailing Address - Zip Code:33870-5536
Mailing Address - Country:US
Mailing Address - Phone:863-471-6575
Mailing Address - Fax:863-471-9188
Practice Address - Street 1:3750 EMERGENCY LN
Practice Address - Street 2:SUITE 2
Practice Address - City:SEBRING
Practice Address - State:FL
Practice Address - Zip Code:33870-5536
Practice Address - Country:US
Practice Address - Phone:863-471-6575
Practice Address - Fax:863-471-9188
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT22490174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLU6958ZMedicare ID - Type Unspecified