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Individual

MR. BENJAMIN FORBES DECKOFF

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
CRNA, MSN

Contact information

Practice address
1210 S OLD DIXIE HWY, JUPITER, FL 33458-7205
(561) 263-2234
Mailing address
16978 75TH PL N, LOXAHATCHEE, FL 33470-5810
(561) 398-5204

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN9292879
FL
367500000X
Certified Registered Nurse Anesthetist
Primary
APRN11003013
FL
367500000X
Certified Registered Nurse Anesthetist
L6-0A10879
DE

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
APRN11003013
FL APRN LICENSE
FL
01
RN9292879
FLORIDA RN LICENSE
FL
Enumeration date
03/27/2019
Last updated
01/07/2026
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