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Individual

BRIAN WAYNE BENSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PA-C

Contact information

Practice address
707 W EAU GALLIE BLVD, MELBOURNE, FL 32935-5958
(321) 727-3223
(321) 727-9448
Mailing address
707 W EAU GALLIE BLVD, MELBOURNE, FL 32935-5958
(321) 727-3223
(321) 727-9448

Taxonomy

Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
PA9102139
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
DC0018
RAILROAD MEDICARE
FL
Enumeration date
02/08/2007
Last updated
11/20/2014
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