Provider Demographics
NPI:1770177446
Name:BENGSTON, PATRICK MITCHEL (APRN)
Entity type:Individual
Prefix:MR
First Name:PATRICK
Middle Name:MITCHEL
Last Name:BENGSTON
Suffix:
Gender:
Credentials:APRN
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Other - Credentials:
Mailing Address - Street 1:15500 ROOSEVELT BLVD
Mailing Address - Street 2:
Mailing Address - City:CLEARWATER
Mailing Address - State:FL
Mailing Address - Zip Code:33760-3430
Mailing Address - Country:US
Mailing Address - Phone:727-310-0831
Mailing Address - Fax:727-222-5950
Practice Address - Street 1:8924 ARABELLA LN
Practice Address - Street 2:
Practice Address - City:SEMINOLE
Practice Address - State:FL
Practice Address - Zip Code:33777-2649
Practice Address - Country:US
Practice Address - Phone:800-991-7630
Practice Address - Fax:800-921-1799
Is Sole Proprietor?:No
Enumeration Date:2021-02-23
Last Update Date:2025-04-01
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLAPRN11011952363LF0000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL109789800Medicaid