Individual
VICTOR BENEZRA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
129 W HIBISCUS BLVD, SUITE A, MELBOURNE, FL 32901-3006
(321) 405-3000
(321) 722-7070
Mailing address
129 W HIBISCUS BLVD STE A, MELBOURNE, FL 32901-3006
(321) 405-3000
(321) 722-7070
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
ME89256
FL
207VG0400X
Gynecology Physician
Primary
ME89256
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
269282100
—
FL
01
—
37523
FLORIDA BLUE
FL
01
—
P01164043
RRMD
FL
Enumeration date
08/29/2005
Last updated
11/13/2018
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