BENTON PEDIATRICS NPI 1093956526

NPI Information

  • NPI: 1093956526
  • Provider Name: BENTON PEDIATRICS
  • Classification: Community Based Residential Treatment Facility, Mental Illness - 320800000X
  • Entity Type: Organization
  • CLIA Number: 10D0271843
  • Address: 5612 NW 43RD ST
    GAINESVILLE, FL
    ZIP 32653
  • Phone: (352) 376-4542

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NPI Details

BENTON PEDIATRICS is a community based residential treatment facility mental illness in Gainesville, FL. The provider is a home-like residential facility providing psychiatric treatment and psycho/social rehabilitative services to individuals diagnosed with mental illness. BENTON PEDIATRICS NPI is 1093956526. The provider is registered as an organization entity type.

The provider's business location address is:

5612 NW 43RD ST
GAINESVILLE, FL
ZIP 32653-332
Phone: (352) 376-4542
Fax: (352) 376-4959

The provider's authorized official is Charles Kent Powers .
The authorized official title is Md/owner and has the following contact phone number (352) 376-4542.

The CLIA number assigned to this NPI record is 10D0271843 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 3/12/2009 and was last updated on 10/17/2024.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. 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
1282NC2000XGeneral Acute Care HospitalChildrenME53353FLORIDANo
2320800000XCommunity Based Residential Treatment Facility, Mental IllnessYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1048463600MEDICAIDFLORIDA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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