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Organization
SHAUGHN C BENNETT DO PA
Active
Organization
SHAUGHN C BENNETT DO PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SHAUGHN C BENNETT D.O. (OWNER/PHYSICIAN)
(305) 926-5844
Entity
Organization
Contact information
Practice address
7575 SW 62ND AVE, SUITE B, SOUTH MIAMI, FL 33143-4955
(305) 661-0181
Mailing address
7575 SW 62ND AVE, SUITE B, SOUTH MIAMI, FL 33143-4955
(305) 661-0181
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
OS5245
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1891758132
NPI
FL
Enumeration date
04/10/2008
Last updated
04/10/2008
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