Provider Demographics
NPI:1740003946
Name:J.B. MEDICAL GROUP OF FLORIDA, PLLC
Entity type:Organization
Organization Name:J.B. MEDICAL GROUP OF FLORIDA, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHANE
Authorized Official - Middle Name:
Authorized Official - Last Name:BENYEHUDA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:407-752-9728
Mailing Address - Street 1:111 N ORANGE AVE STE 800
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32801-2381
Mailing Address - Country:US
Mailing Address - Phone:407-752-9728
Mailing Address - Fax:727-292-1156
Practice Address - Street 1:111 N ORANGE AVE STE 800
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32801-2381
Practice Address - Country:US
Practice Address - Phone:407-752-9728
Practice Address - Fax:727-292-1156
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-11-05
Last Update Date:2024-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult MedicineGroup - Single Specialty