Provider Demographics
NPI:1184806838
Name:M. BENJAMIN MEYERS, PSYD, PA
Entity type:Organization
Organization Name:M. BENJAMIN MEYERS, PSYD, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:BENJAMIN
Authorized Official - Last Name:MEYERS
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:239-213-0051
Mailing Address - Street 1:751 92ND AVE N
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34108-2432
Mailing Address - Country:US
Mailing Address - Phone:239-213-0051
Mailing Address - Fax:239-352-0737
Practice Address - Street 1:751 92ND AVE N
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34108-2432
Practice Address - Country:US
Practice Address - Phone:239-213-0051
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-04
Last Update Date:2021-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY7046103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLK7266Medicare PIN