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Individual
TIFFANY C. BENTON
Active
Individual
TIFFANY C. BENTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
ARNP3090422
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3063542 00
—
FL
01
—
G3553
BCBS
FL
01
—
P00225323
RAILROAD MEDICARE
—
01
—
XXX-XX-9708
TRICARE - SOUTH REGION
—
Enumeration date
07/21/2006
Last updated
01/15/2013
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