Active NPI
Alexis Benjamin
- Adult Health Nurse Practitioner
- Orlando, FL
National Provider Identifier
1063007391
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Adult Health Nurse Practitioner
- License
- 11012023
- Practice address
- 7450 Dr Phillips Blvd Ste 205
Orlando, FL 32819-5120 - Phone
- (407) 233-4006
- NPI assigned
- Mar 8, 2021
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Adult Health Nurse Practitioner | 363LA2200X | 11012023 | FL | Primary |
Addresses
Primary practice location
7450 Dr Phillips Blvd Ste 205
Orlando, FL 32819-5120
Mailing address
302 Gulfview Dr
Largo, FL 33770-4004
Phone (727) 542-3587
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | eClinicalWorks | Direct |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 11012023 | FL | MD | Adult Health Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1615161600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1615161600000",
"number": "1063007391",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "302 GULFVIEW DR",
"city": "LARGO",
"state": "FL",
"postal_code": "337704004",
"telephone_number": "727-542-3587"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7450 DR PHILLIPS BLVD STE 205",
"city": "ORLANDO",
"state": "FL",
"postal_code": "328195120",
"telephone_number": "407-233-4006"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BENJAMIN",
"first_name": "ALEXIS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-03-08",
"last_updated": "2021-03-08",
"certification_date": "2021-03-08",
"status": "A"
},
"taxonomies": [
{
"code": "363LA2200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Adult Health",
"state": "FL",
"license": "11012023",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "eClinicalWorks",
"affiliation": "N",
"use": "DIRECT",
"useDescription": "Direct",
"address_1": "7450 Dr Phillips Blvd Ste 205",
"city": "Orlando",
"state": "FL",
"country_code": "US",
"postal_code": "328195120",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Orlando, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.