Provider Demographics
NPI:1780897082
Name:AMEDEE-BENJAMIN, FREDELINE D (DC)
Entity type:Individual
Prefix:DR
First Name:FREDELINE
Middle Name:D
Last Name:AMEDEE-BENJAMIN
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5335 N MILITARY TRL STE 44
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33407-3033
Mailing Address - Country:US
Mailing Address - Phone:561-683-6638
Mailing Address - Fax:561-683-6684
Practice Address - Street 1:5335 N MILITARY TRL STE 44
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33407-3033
Practice Address - Country:US
Practice Address - Phone:561-683-6638
Practice Address - Fax:561-683-6684
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH8672111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor