Provider Demographics
NPI:1336246958
Name:BENDT, JOHN DAVID (OPA-C)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:DAVID
Last Name:BENDT
Suffix:
Gender:M
Credentials:OPA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:6784 MAGNOLIA LN
Mailing Address - Street 2:
Mailing Address - City:ST AUGUSTINE
Mailing Address - State:FL
Mailing Address - Zip Code:32086-7500
Mailing Address - Country:US
Mailing Address - Phone:904-825-0540
Mailing Address - Fax:904-825-2490
Practice Address - Street 1:1 ORTHOPAEDIC PL
Practice Address - Street 2:
Practice Address - City:ST AUGUSTINE
Practice Address - State:FL
Practice Address - Zip Code:32086-4202
Practice Address - Country:US
Practice Address - Phone:904-825-0540
Practice Address - Fax:904-825-2490
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-17
Last Update Date:2013-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZS0410XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Technologist