Provider Demographics
NPI:1255436036
Name:BENOIT, EDDY (MD)
Entity type:Individual
Prefix:
First Name:EDDY
Middle Name:
Last Name:BENOIT
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 1:312 HENLEY DR
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34104
Mailing Address - Country:US
Mailing Address - Phone:239-312-3611
Mailing Address - Fax:
Practice Address - Street 1:6075 BATHEY LN
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34116-7536
Practice Address - Country:US
Practice Address - Phone:239-455-8500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-14
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME417762084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL263102400Medicaid
FLBB0416289OtherDEA
FL263102400Medicaid
FLD63180Medicare UPIN