Active NPI
Tito Jovan Benjamin, B.A., ED.S., ED.D.
- School Psychologist
- Eatonville, FL
National Provider Identifier
1730506874
On this page
Key facts
NPPES NPI Registry- Primary specialty
- School Psychologist
- License
- SS1010
- Practice address
- 323 E Kennedy Blvd
Suite G
Eatonville, FL 32751-5381 - Phone
- (407) 463-9119
- NPI assigned
- Mar 26, 2014
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| School Psychologist | 103TS0200X | SS1010 | FL | Primary |
Addresses
Primary practice location
323 E Kennedy Blvd
Suite G
Eatonville, FL 32751-5381
Mailing address
323 E Kennedy Blvd
Suite G
Eatonville, FL 32751-5381
Phone (407) 463-9119
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
- Credentials
- Bachelor of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| SS1010 | FL | MD | School Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1395792000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1395792000000",
"number": "1730506874",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "323 E KENNEDY BLVD",
"address_2": "SUITE G",
"city": "EATONVILLE",
"state": "FL",
"postal_code": "327515381",
"telephone_number": "407-463-9119"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "323 E KENNEDY BLVD",
"address_2": "SUITE G",
"city": "EATONVILLE",
"state": "FL",
"postal_code": "327515381",
"telephone_number": "407-463-9119"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BENJAMIN",
"first_name": "TITO",
"middle_name": "JOVAN",
"name_prefix": "Dr.",
"credential": "B.A., ED.S., ED.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2014-03-26",
"last_updated": "2014-03-26",
"status": "A"
},
"taxonomies": [
{
"code": "103TS0200X",
"taxonomy_group": "",
"desc": "Psychologist, School",
"state": "FL",
"license": "SS1010",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Eatonville, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.