Individual
DR. JOHNNY C. BENJAMIN JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1355 37TH ST, SUITE 301, VERO BEACH, FL 32960-7320
(772) 978-7808
(772) 978-9320
Mailing address
1355 37TH ST, SUITE 301, VERO BEACH, FL 32960-7320
(772) 978-7808
(772) 978-9320
Taxonomy
Speciality
Code
Description
License number
State
207XS0117X
Orthopaedic Surgery of the Spine Physician
Primary
ME 0070165
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
200040285
RAILROAD MEDICARE
FL
05
—
250692100
—
FL
01
—
28917
BLUE CROSS BLUE SHIELD FL
FL
01
—
4295190001
PALMETTO
FL
01
—
593604327
CHAMPUS
FL
Enumeration date
07/07/2006
Last updated
06/11/2013
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