Benjamin, Latanya Tamara

Benjamin, Latanya Tamara is an individual health care provider with primary practice located at 5200 S University Dr Ste 102 , Davie FL 33328-5316. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Dermatology, Allopathic & Osteopathic Physicians / Pediatric Dermatology. Allopathic & Osteopathic Physicians / Pediatric Dermatology is her primary health care specialty. Benjamin, Latanya Tamara can be contacted via phone (954) 242-4275.

Contact Information

Primary practice address
5200 S University Dr Ste 102 Davie FL 33328-5316
Phone: (954) 242-4275
Fax: (954) 530-5562
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Dermatology 207N00000X A110104 California
Allopathic & Osteopathic Physicians / Dermatology 207N00000X ME88650 Florida
Allopathic & Osteopathic Physicians / Pediatric Dermatology 207NP0225X ME88650 Florida

Profile Details

NPI number 1417167057
LBN Legal business name Benjamin, Latanya Tamara
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 23rd, 2007
Last updated Mar 10th, 2020 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1417167057 NPPES
Florida MEDICAID 014388600

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