Organization
BENGSTON FAMILY PRACTICE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EVELYN SUSANNE BENGSTON ARNP (ARNP)
(863) 675-0550
Entity
Organization
Contact information
Practice address
870 W HICKPOCHEE AVE, SSUITE 1700, LABELLE, FL 33935-4313
(863) 675-0550
(863) 675-0553
Mailing address
870 W HICKPOCHEE AVE, SSUITE 1700, LABELLE, FL 33935-4313
(863) 675-0550
(863) 675-0553
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
ARNP2209102
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
302076200
—
FL
Enumeration date
03/03/2012
Last updated
03/07/2012
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