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Individual

DR. BENJAMIN NMN MENA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
2835 W DE LEON ST, SUITE 104, TAMPA, FL 33609-4130
(813) 443-0606
(813) 443-0608
Mailing address
2835 W DE LEON ST, SUITE 104, TAMPA, FL 33609-4130
(813) 443-0606
(813) 443-0608

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
ME98740
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0421861
UNITED HEALTHCARE
FL
01
10919106
CAQH ID
FL
01
6116907
CIGNA
FL
01
78355
BLUE CROSS BLUE SHIELD ALL PLANS
FL
01
7904315
AETNA
FL
01
AH232Y
MEDICARE INDIVIDUAL PTAN
FL
Enumeration date
01/03/2006
Last updated
03/07/2023
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