Individual
DR. BENJAMIN COLE CORNETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
52 W UNDERWOOD ST, ORLANDO, FL 32806-1110
(321) 842-8475
(407) 849-6470
Mailing address
52 W UNDERWOOD ST, ORLANDO, FL 32806-1110
(321) 842-8475
(407) 849-6470
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
LL29761
SC
2085R0202X
Diagnostic Radiology Physician
Primary
ME113515
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
006102000
—
FL
01
—
14KX4
BCBS
FL
01
—
GI538W
MEDICARE PTAN OHRI
FL
01
—
PR957
MEDICARE PTAN OHMG
FL
Enumeration date
07/10/2007
Last updated
03/24/2023
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