Individual
MARY J BENSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1717 N E ST, STE 205, PENSACOLA, FL 32501-6336
(850) 434-1863
(850) 432-9090
Mailing address
1717 N E ST, STE 205, PENSACOLA, FL 32501-6336
(850) 434-1863
(850) 432-9090
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
ME58043
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
064663600
—
FL
01
—
100003795
RRB PTAN
FL
Enumeration date
07/21/2006
Last updated
06/18/2008
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