Provider Demographics
NPI:1932721107
Name:DR. B'S KIDS, PA
Entity Type:Organization
Organization Name:DR. B'S KIDS, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:
Authorized Official - Last Name:BENITEZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:352-332-2345
Mailing Address - Street 1:215 NW 138TH TER STE 100
Mailing Address - Street 2:
Mailing Address - City:NEWBERRY
Mailing Address - State:FL
Mailing Address - Zip Code:32669-2090
Mailing Address - Country:US
Mailing Address - Phone:352-332-2345
Mailing Address - Fax:352-332-2394
Practice Address - Street 1:215 NW 138TH TER STE 100
Practice Address - Street 2:
Practice Address - City:NEWBERRY
Practice Address - State:FL
Practice Address - Zip Code:32669-2090
Practice Address - Country:US
Practice Address - Phone:352-332-2345
Practice Address - Fax:352-332-2394
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-05-11
Last Update Date:2020-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty