Organization
BENAKANAHALLI MD PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MANJUNATH B BENAKANAHALLI MD (OWNER)
(813) 435-3912
Entity
Organization
Contact information
Practice address
603 W LUMSDEN RD, BRANDON, FL 33511-5911
(813) 435-3912
(813) 655-3913
Mailing address
603 W LUMSDEN RD, BRANDON, FL 33511-5911
(813) 435-3912
(813) 655-3913
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
ME97496
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
ME97496
MEDICAL LICENSE
FL
Enumeration date
11/03/2009
Last updated
04/01/2024
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