Individual
MR. JOHN DOMINICK BENEVENTO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
2825 N STATE ROAD 7 STE 204, MARGATE, FL 33063-5737
(954) 451-3002
Mailing address
4800 NE 20TH TER STE 303, FT LAUDERDALE, FL 33308-4510
(954) 771-8177
(945) 771-3629
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
25858
FL
2251X0800X
Orthopedic Physical Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
016620700
—
FL
Enumeration date
11/30/2010
Last updated
02/13/2020
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