Provider Demographics
NPI:1770725343
Name:BENYEHUDA, JOHANE (MD)
Entity type:Individual
Prefix:DR
First Name:JOHANE
Middle Name:
Last Name:BENYEHUDA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
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
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-29
Last Update Date:2024-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA082061207Q00000X
DEC10013010207Q00000X
OH35.135131207Q00000X
TN58484207Q00000X
CODR.0071935207Q00000X
NC202303017207QA0505X
FLME105517207QA0505X
PAMD436387207QA0505X
NY307372207QA0505X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult Medicine
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL1074191OtherCAREPLUS
FL9209453OtherCIGNA HEALTHCARE
FLP00773989OtherRAILROAD MEDICARE
FL003090320OtherUNITED
FL330967OtherAVMED
FL9872407OtherAETNA
FL001468000Medicaid
FL146HUOtherBCBS OF FLORIDA
FL146HUOtherBCBS OF FLORIDA