| Demetra Bennett Arnp Llc | |
|
3628 Harden Blvd Lakeland FL 33803-5938 | |
| (863) 701-2225 | |
| Not Available |
| Full Name | Demetra Bennett Arnp Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 3628 Harden Blvd, Lakeland, Florida |
| Authorized Official Name and Position | Demetra Bennett (OWNER) |
| Authorized Official Contact | 3525850768 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Demetra Bennett Arnp Llc 3628 Harden Blvd Lakeland FL 33803-5938 Ph: (863) 701-2225 | Demetra Bennett Arnp Llc 3628 Harden Blvd Lakeland FL 33803-5938 Ph: (863) 701-2225 |
| NPI Number | 1992022313 |
|---|---|
| Provider Enumeration Date | 04/25/2010 |
| Last Update Date | 04/25/2010 |
| Medicare PECOS PAC ID | 2769674241 |
|---|---|
| Medicare Enrollment ID | O20101004000554 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1992022313 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | 9164847 (Florida) | Primary |
| Provider Name | Demetra Bennett |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184676025 PECOS PAC ID: 3072580489 Enrollment ID: I20040915000332 |
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