Individual
MRS. GENORA MICHELLE BENTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
10209 N 22ND ST, TAMPA, FL 33612
(813) 975-0280
(813) 631-1429
Mailing address
10209 N 22ND ST, TAMPA, FL 33612
(813) 975-0280
(813) 631-1429
Taxonomy
Speciality
Code
Description
License number
State
106E00000X
Assistant Behavior Analyst
—
—
253Z00000X
In Home Supportive Care Agency
—
—
372500000X
Chore Provider
—
—
372600000X
Adult Companion
6923844
FL
372600000X
Adult Companion
692384496
FL
372600000X
Adult Companion
—
—
376J00000X
Homemaker
Primary
235260
FL
385H00000X
Respite Care
—
—
385HR2065X
Child Physical Disabilities Respite Care
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
692384496
—
FL
05
—
692384498
—
FL
Enumeration date
07/26/2007
Last updated
03/15/2023
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