Latanya Tamara Benjamin, M.D.

Primary specialty

Pediatric Dermatology PhysicianTaxonomy code 207NP0225X

License

ME88650 Issued in FL

Practice address

5200 S University Dr Ste 102
Davie, FL 33328-5316

Phone

(954) 242-4275

Fax

(954) 530-5562

NPI assigned

May 23, 2007

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Young Skin, P.a.

  • Pediatric Dermatology Physician
  • Davie, FL
  • NPI 1144855172
  NPD Authorized official
• Ciocca Health Group PA

  • Specialist
  • Miami, FL
  • NPI 1255792842
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1179878400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1583798400000",
    "number": "1417167057",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11076 MERIDIAN DR N",
            "city": "PARKLAND",
            "state": "FL",
            "postal_code": "330764592",
            "telephone_number": "954-821-1331"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5200 S UNIVERSITY DR STE 102",
            "city": "DAVIE",
            "state": "FL",
            "postal_code": "333285316",
            "telephone_number": "954-242-4275",
            "fax_number": "954-530-5562"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENJAMIN",
        "first_name": "LATANYA",
        "middle_name": "TAMARA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-23",
        "last_updated": "2020-03-10",
        "certification_date": "2020-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "CA",
            "license": "A110104",
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "FL",
            "license": "ME88650",
            "primary": false
        },
        {
            "code": "207NP0225X",
            "taxonomy_group": "",
            "desc": "Dermatology, Pediatric Dermatology",
            "state": "FL",
            "license": "ME88650",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "014388600",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Nicole Bencomo
• Idamaris Bencosme Santiesteban
• Dipsya Bengoachea
• Melanie Rose Benitez
• Vanessa Benitez
• Michele Benjamin, MD, MBA
• Verdell Benjamin
• Bennett L. Wolansky, DPM, PA (University Podiatry Associates)
• Joshua Bennett, OTR/L
• Barnette Benoit, FNP

• Pediatric Dermatology Physician in Davie, FL
• Providers in Davie, FL by specialty
• Pediatric Dermatology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.