Organization
JOHNNY C. BENJAMIN JR. M.D., PA
Active
Organization
JOHNNY C. BENJAMIN JR. M.D., PA
Active
Other names
PRO SPINE
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. AMANDA P MULLIKIN (ADMIN ASSIST)
(772) 978-7808
Entity
Organization
Contact information
Practice address
1355 37TH ST, SUITE 301, VERO BEACH, FL 32960-7320
(772) 978-7808
(772) 978-9320
Mailing address
1355 37TH ST, SUITE 301, VERO BEACH, FL 32960-7320
(772) 978-7808
(772) 978-9320
Taxonomy
Speciality
Code
Description
License number
State
207LP2900X
Pain Medicine (Anesthesiology) Physician
—
—
207XS0117X
Orthopaedic Surgery of the Spine Physician
Primary
—
—
2081P2900X
Pain Medicine (Physical Medicine & Rehabilitation) Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
45410
BLUE CROSS BLUE SHIELD FL
FL
Enumeration date
07/04/2006
Last updated
01/06/2016
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