Individual
DR. MICHAEL A BENGTSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3515 E FLETCHER AVE, TAMPA, FL 33613-4706
(813) 974-8900
Mailing address
PO BOX 917770, ORLANDO, FL 32891-7770
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
ME58887
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
23209
BLUE CROSS BLUE SHIELD
FL
05
—
372997400
—
FL
Enumeration date
07/05/2006
Last updated
09/02/2008
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