Provider Demographics
NPI:1295166726
Name:BENONY, EMMANUEL DANIEL (PHYSICAL THERAPY DPT)
Entity type:Individual
Prefix:
First Name:EMMANUEL
Middle Name:DANIEL
Last Name:BENONY
Suffix:
Gender:M
Credentials:PHYSICAL THERAPY DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5055 NORTHERN LIGHTS DR
Mailing Address - Street 2:
Mailing Address - City:GREENACRES
Mailing Address - State:FL
Mailing Address - Zip Code:33463-5938
Mailing Address - Country:US
Mailing Address - Phone:561-808-3030
Mailing Address - Fax:
Practice Address - Street 1:2393 S CONGRESS AVE STE 125
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33406
Practice Address - Country:US
Practice Address - Phone:561-253-6382
Practice Address - Fax:561-253-0437
Is Sole Proprietor?:No
Enumeration Date:2013-12-10
Last Update Date:2019-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
2251G0304X
FLPT27961225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No2251G0304XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGeriatrics