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Individual

JONATHAN C BENNETT

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
CRNA

Contact information

Practice address
10301 GATEWAY BLVD W, EL PASO, TX 79925-7701
(915) 595-9000
Mailing address
1 TAMPA GENERAL CIR OFC, SUITE A327, TAMPA, FL 33606-3571
(813) 844-4434
(813) 844-4972

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
2946
CA
367500000X
Certified Registered Nurse Anesthetist
Primary
AP112158
TX
367500000X
Certified Registered Nurse Anesthetist
ARNP9181218
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
305016500
FL
01
G3173
BCBS FLORIDA
FL
01
G3173M
MEDICARE
FL
Enumeration date
06/03/2006
Last updated
07/19/2016
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