Individual
KEITH M BENBENISTY
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
8381 RIVERWALK PARK BLVD, SUITE 101, FORT MYERS, FL 33919-8760
(239) 936-5425
(239) 936-5176
Mailing address
8381 RIVERWALK PARK BLVD, SUITE 101, FORT MYERS, FL 33919-8760
(239) 936-5425
(239) 936-5176
Taxonomy
Speciality
Code
Description
License number
State
207NS0135X
Procedural Dermatology Physician
Primary
ME92553
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
03456
BC BS OF FLA
FL
01
—
3795279
AETNA
FL
01
—
6555071
CIGNA
FL
01
—
P00237559
RR MEDICARE
FL
Enumeration date
04/07/2006
Last updated
07/08/2007
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