Benedict Inlayo Florentin, RPT

Individual provider Active NPI Physical Therapist · Bonifay, FL

NPI 1508201435 · NPPES record last updated Feb 24, 2014

Key facts

NPI
1508201435
Entity type
Individual (NPI type 1)
Primary specialty
Physical Therapist 225100000X
License
PT 27336 (FL)
Practice address
503 W Montana Ave
Bonifay, FL 32425-1515
Phone
(646) 399-5272
NPI assigned
May 6, 2013
Sex
Male
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
PT 27336FLMDPhysical Therapist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT 27336 FL Yes

Addresses

Primary practice location

503 W Montana Ave
Bonifay, FL 32425-1515

Mailing address

503 W Montana Ave
Bonifay, FL 32425-1515
Phone (646) 399-5272

Other providers in Bonifay, FL

All providers in Bonifay, FL · Physical Therapist in Florida

Sources for this page

Verify at the official NPI Registry.