Individual
BENTON NG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
601 5TH ST S, ST PETERSBURG, FL 33701-4804
(727) 767-3333
(727) 767-8990
Mailing address
601 5TH ST S, ST PETERSBURG, FL 33701-4804
(727) 767-3333
(727) 767-8990
Taxonomy
Speciality
Code
Description
License number
State
2080P0202X
Pediatric Cardiology Physician
40200
IA
2080P0202X
Pediatric Cardiology Physician
Primary
ME125328
FL
390200000X
Student in an Organized Health Care Education/Training Program
—
WI
Other
Enumeration date
06/22/2006
Last updated
11/10/2021
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