Individual
BENNY RAY WILKERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
601 E ROLLINS ST, ORLANDO, FL 32803-1248
(407) 303-6413
(407) 303-6414
Mailing address
601 E ROLLINS ST, ORLANDO, FL 32803-1248
(407) 303-6413
(407) 303-6414
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA9102065
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
051556081
—
AL
Enumeration date
05/18/2006
Last updated
01/25/2023
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