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Individual

BENIGNO FELICIANO

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1109 BRYN MAWR AVE, LAKE WALES, FL 33853-4333
(863) 679-2984
(863) 676-2086
Mailing address
1109 BRYN MAWR AVE, LAKE WALES, FL 33853-4333
(863) 679-2984
(863) 676-8026

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
ME87151
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
270356400
FL
Enumeration date
11/21/2005
Last updated
03/15/2016
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