Organization
DOCTORS AT HOME LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DALTON M BENSON M.D. (OWNER)
(352) 597-3511
Entity
Organization
Contact information
Practice address
11479 CORTEZ BLVD, BROOKSVILLE, FL 34613-7367
(352) 592-7777
(352) 592-1155
Mailing address
15215 CORTEZ BLVD, BROOKSVILLE, FL 34613-6072
(352) 799-0046
(352) 799-0115
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
2005-00475004
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P01046782
RAILROAD MEDICARE ATTACHED TO GRP# DR6927
FL
Enumeration date
05/16/2006
Last updated
07/25/2012
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