Individual
BENET FANFAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
5941 STRAWBERRY LAKES CIR, LAKE WORTH, FL 33463-6507
(561) 568-5728
Mailing address
5941 STRAWBERRY LAKES CIR, LAKE WORTH, FL 33463-6507
(561) 568-5728
Taxonomy
Speciality
Code
Description
License number
State
363LP2300X
Primary Care Nurse Practitioner
Primary
11007924
FL
Other
Enumeration date
07/06/2020
Last updated
07/06/2020
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