Provider Demographics
NPI:1265066450
Name:SABEN, BENNYTA
Entity type:Individual
Prefix:
First Name:BENNYTA
Middle Name:
Last Name:SABEN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1685
Mailing Address - Street 2:
Mailing Address - City:PALM HARBOR
Mailing Address - State:FL
Mailing Address - Zip Code:34682-1685
Mailing Address - Country:US
Mailing Address - Phone:727-287-6300
Mailing Address - Fax:
Practice Address - Street 1:3161 HOWELL MILL RD NW STE 310
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30327-2132
Practice Address - Country:US
Practice Address - Phone:404-351-5812
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-02-26
Last Update Date:2020-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist