DR. LATANYA TAMARA BENJAMIN M.D. NPI 1417167057

NPI Information

NPI: 1417167057
Provider Name: DR. LATANYA TAMARA BENJAMIN, M.D.
Classification: Dermatology - 207NP0225X
Entity Type: Individual

Specialization: Pediatric Dermatology

PECOS Registration: Yes

Address:
5200 S UNIVERSITY DR STE 102
DAVIE, FL
ZIP 33328
Phone: (954) 242-4275
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DR. Latanya Tamara Benjamin, M.D. is a pediatric dermatology dermatology in Davie, FL. The provider is a pediatric dermatologist has, through additional special training, developed expertise in the treatment of specific skin disease categories with emphasis on those diseases which predominate in infants, children and adolescents. DR. Latanya Tamara Benjamin, M.D. NPI is 1417167057. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

5200 S UNIVERSITY DR STE 102
DAVIE, FL
ZIP 33328-316
Phone: (954) 242-4275
Fax: (954) 530-5562

The NPI 1417167057 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Power Mobility Devices.

The enumeration date for this NPI number is 5/23/2007 and was last updated on 3/10/2020.

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	207N00000X	Dermatology		A110104	CALIFORNIA	No
2	207N00000X	Dermatology		ME88650	FLORIDA	No
3	207NP0225X	Dermatology	Pediatric Dermatology	ME88650	FLORIDA	Yes

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	014388600	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: 5/5/2024

NPI Synchronization or Removal

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