Marie Benson, TATTOO SPECIALIST

Individual provider Active NPI Medical Art Specialist/Technologist · Estero, FL

NPI 1760837835 · NPPES record last updated Apr 26, 2016

Key facts

NPI
1760837835
Entity type
Individual (NPI type 1)
Primary specialty
Medical Art Specialist/Technologist 246ZA2600X
License
1441581056 (FL)
Practice address
20400 Trailside Dr
Estero, FL 33928-2146
Phone
(239) 728-1234
Fax
(239) 949-7737
NPI assigned
Apr 26, 2016
Sex
Female
Sole proprietor
Yes

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
1441581056FLMDMedical Art Specialist/Technologist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Art Specialist/Technologist 246ZA2600X 1441581056 FL Yes

Addresses

Primary practice location

20400 Trailside Dr
Estero, FL 33928-2146

Mailing address

20400 Trailside Dr
Estero, FL 33928-2146
Phone (239) 728-1234

Other providers in Estero, FL

All providers in Estero, FL · Medical Art Specialist/Technologist in Florida

Sources for this page

Verify at the official NPI Registry.