Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225100000X | Physical Therapist | PT27961 | FL |
N | 2251G0304X | Physical Therapist - Geriatrics |
NPI | 1295166726 |
---|---|
Provider Name | Emmanuel Daniel Benony |
First Address | Greenacres, FL 33463-5938 |
Second Address | West Palm Beach, FL 33406 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/12/2013 |
Last Update Date | 11/06/2019 |