Individual
BETTY BENCOSME
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PAT
Contact information
Practice address
3276 GREENWALD WAY N, KISSIMMEE, FL 34741-0728
(407) 944-0999
(407) 935-0691
Mailing address
3276 GREENWALD WAY N, KISSIMMEE, FL 34741-0728
(407) 944-0999
(407) 935-0691
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PAT9108277
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PAT9108277
FLORIDA LICENSE NUMBER
FL
Enumeration date
09/26/2014
Last updated
09/26/2014
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