Individual
BRUCE JOSEPH BENAGLIO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
14961 W BELL RD, STE 175, SURPRISE, AZ 85374-3200
(623) 242-9830
(623) 243-6733
Mailing address
14961 W BELL RD, STE 175, SURPRISE, AZ 85374-3200
(623) 242-9830
(623) 243-6733
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
2752
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
489355
—
AZ
Enumeration date
09/19/2009
Last updated
03/18/2010
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