BENNETT W MCALLISTER MD PA NPI 1104154053

NPI Information

NPI: 1104154053
Provider Name: BENNETT W MCALLISTER MD PA
Classification: Clinic/Center - 261QM0801X
Specialization: Mental Health (Including Community Mental Health Center)
Entity Type: Organization
:
Address: 4161 TAMIAMI TRL STE 304D
PORT CHARLOTTE, FL
ZIP 33952
Phone: (941) 625-5895

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NPI Details

BENNETT W MCALLISTER MD PA is a mental health (including community mental health center) clinic center in Port Charlotte, FL. BENNETT W MCALLISTER MD PA NPI is 1104154053. The provider is registered as an organization entity type and is a single specialty group.
The provider .

The provider's business location address is:

4161 TAMIAMI TRL STE 304D
PORT CHARLOTTE, FL
ZIP 33952-254
Phone: (941) 625-5895
Fax: (941) 625-1047

The provider's authorized official is Bennett William Mcallister .
The authorized official title is Owner and has the following contact phone number (941) 625-5895.

The enumeration date for this NPI number is 12/3/2009 and was last updated on 4/26/2025.

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
1	2084P0800X	Psychiatry & Neurology	Psychiatry	ME104685	FLORIDA	No
2	2084P0800X	Psychiatry & Neurology	Psychiatry			No
3	261QM0801X	Clinic/Center	Mental Health (Including Community Mental Health Center)			Yes
4	261QM0850X	Clinic/Center	Adult Mental Health			No

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
1	001284200	MEDICAID	FLORIDA
2	114514100	MEDICAID	FLORIDA

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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