Individual
BENJAMIN OLSON DICKEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CAA
Contact information
Practice address
800 PRUDENTIAL DR, JACKSONVILLE, FL 32207-8202
(904) 202-2000
Mailing address
820 PRUDENTIAL DR STE 606, JACKSONVILLE, FL 32207-8208
Taxonomy
Speciality
Code
Description
License number
State
367H00000X
Anesthesiologist Assistant
28512091
GA
367H00000X
Anesthesiologist Assistant
Primary
AA550
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PENDING
—
FL
Enumeration date
10/07/2019
Last updated
01/24/2023
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