The Benjamin Wellness Center South

Primary specialty

SpecialistTaxonomy code 174400000X

Legal business name

THE BENJAMIN WELLNESS CENTER SOUTH

Doing business as

Benjamin Outreach Medical Network Corporation

Practice address

10300 Sunset Dr
Ste #280
Miami, FL 33173-3012

Phone

(305) 901-2209

Fax

(305) 901-2189

NPI assigned

Oct 6, 2015

Organization subpart

Yes

Parent organization

BENJAMIN OUTREACH MEDICAL NETWORK CORPORATIONAs reported in NPPES

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

Authorized official

Name

Ilnise Mathieu

Title

Director of Operation

Phone

(954) 251-0267

Specialties & licenses 1

Addresses

Other names 1

• BENJAMIN OUTREACH MEDICAL NETWORK CORPORATION Doing business as

Tax ID family

Benjamin Outreach Medical Network Corporation2 organizations share this tax ID, including this one

Part of

Benjamin Outreach Medical Network Corporation

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Benjamin Outreach Medical Network Corporation

  dba Benjamin Wellness Center of Hollywood

  • Health Service Clinic/Center
  • Hollywood, FL
  • NPI 1518248418
  NPD tax ID

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

• Benjamin Outreach Medical Network Corporation

  dba Benjamin Wellness Center of Hollywood

  • Health Service Clinic/Center
  • Hollywood, FL
  • NPI 1518248418
  NPPES parent name

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Vaunrance J Benjamin, MD MPH

  • General Practice Physician
  • Hollywood, FL
  • NPI 1831178706
  NPD

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

{
    "created_epoch": "1444089600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1444089600000",
    "number": "1790155455",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10300 SUNSET DR",
            "address_2": "STE #280",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331733012",
            "telephone_number": "305-901-2209",
            "fax_number": "305-901-2189"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10300 SUNSET DR",
            "address_2": "STE #280",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331733012",
            "telephone_number": "305-901-2209",
            "fax_number": "305-901-2189"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE BENJAMIN WELLNESS CENTER SOUTH",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "BENJAMIN OUTREACH MEDICAL NETWORK CORPORATION",
        "enumeration_date": "2015-10-06",
        "last_updated": "2015-10-06",
        "status": "A",
        "authorized_official_last_name": "MATHIEU",
        "authorized_official_first_name": "ILNISE",
        "authorized_official_title_or_position": "DIRECTOR OF OPERATION",
        "authorized_official_telephone_number": "954-251-0267"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "BENJAMIN OUTREACH MEDICAL NETWORK CORPORATION",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Specialist in Miami, FL
• Providers in Miami, FL by specialty
• Specialist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2015; 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.