BENNETT PEDIATRICS, LLC - NPI NUMBER 1992131080

Summary

Provider Name: BENNETT PEDIATRICS, LLC

NPI Number: 1992131080

Clasification: Pediatrics (208000000X)

Address:
365 CITRUS TOWER BLVD
SUITE 104
CLERMONT, FL
ZIP 34711

Phone Number: (352) 404-7728



Detailed Information

BENNETT PEDIATRICS, LLC is a pediatrician in Clermont, FL. The provider is a pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. The assigned NPI number for this provider is 1992131080 and is registered as an organization entity type and is a single specialty group.

The provider's business address is:

365 CITRUS TOWER BLVD
SUITE 104
CLERMONT, FL
ZIP 34711-532
Phone: (352) 404-7728
Fax: (352) 404-7724

The provider's authorized official is Lorna Bennett .
The authorized official title is Owner/pediatrician and has the following contact phone number (352) 978-3182.

The enumeration date for this NPI number is 9/19/2013 and was last updated on 11/14/2013.

Map - Location of Practice

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Taxonomy Codes

The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1 208000000X Pediatrics ME91225 FL Yes

NPI Record

No. Field Name Field Value
1 NPI 1992131080
2 Entity Type Code 2
3 Employer Identification Number EIN
4 Provider Organization Name Legal Business Name BENNETT PEDIATRICS, LLC
5 Provider First Line Business Practice Location Address 365 CITRUS TOWER BLVD
6 Provider Second Line Business Practice Location Address SUITE 104
7 Provider Business Practice Location Address City Name CLERMONT
8 Provider Business Practice Location Address State Name FL
9 Provider Business Practice Location Address Postal Code 347116532
10 Provider Business Practice Location Address Country Code If outside U S US
11 Provider Business Practice Location Address Telephone Number 3524047728
12 Provider Business Practice Location Address Fax Number 3524047724
13 Provider Enumeration Date 9/19/2013
14 Last Update Date 11/14/2013
15 Authorized Official Last Name BENNETT
16 Authorized Official First Name LORNA
17 Authorized Official Title or Position OWNER/PEDIATRICIAN
18 Authorized Official Telephone Number 3529783182
19 Healthcare Provider Taxonomy Code 1 208000000X
20 Provider License Number 1 ME91225
21 Provider License Number State Code 1 FL
22 Healthcare Provider Primary Taxonomy Switch 1 Y
23 Is Organization Subpart N
24 Authorized Official Name Prefix Text DR.
25 Authorized Official Credential Text M.D.,
26 Healthcare Provider Taxonomy Group 1 193400000X SINGLE SPECIALTY GROUP

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This page was last updated on: 8/12/2014
All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.