Individual
BENEDICT LABRADOR EBUEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
1536 N JEFFERSON ST, JACKSONVILLE, FL 32209-6525
(904) 475-5800
(904) 301-2502
Mailing address
1536 N JEFFERSON ST, JACKSONVILLE, FL 32209-6525
(904) 475-5800
(904) 301-2502
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA9101700
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2911027-00
—
FL
05
—
657342142A
—
GA
Enumeration date
03/04/2006
Last updated
04/12/2013
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