Provider Demographics
NPI:1679376719
Name:BENJAMIN, ASHLIE ANTONIETTE (BS, RN, BSN, CLC)
Entity type:Individual
Prefix:
First Name:ASHLIE
Middle Name:ANTONIETTE
Last Name:BENJAMIN
Suffix:
Gender:
Credentials:BS, RN, BSN, CLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1080 PALOS VERDE DR
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32825-8339
Mailing Address - Country:US
Mailing Address - Phone:813-422-3399
Mailing Address - Fax:
Practice Address - Street 1:333 W MAIN ST
Practice Address - Street 2:
Practice Address - City:APOPKA
Practice Address - State:FL
Practice Address - Zip Code:32712-3451
Practice Address - Country:US
Practice Address - Phone:407-595-5054
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-31
Last Update Date:2025-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9620575163WL0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WL0100XNursing Service ProvidersRegistered NurseLactation Consultant