Ida Wallace Bennett Family Corporation

LBN: Ida Wallace Bennett Family Health Corporation
Ida Wallace Bennett Family Corporation is an health care organization with primary practice located at 331 N Deerfield Ave , Deerfield Beach FL 33441-2028. The organization recently has 2 registered licenses in different health care specialties including Ambulatory Health Care Facilities / Health Service, Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner. Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner is the primary health care specialty. Ida Wallace Bennett Family Health Corporation can be contacted via phone (561) 900-6737, or through Johnson, Pamela V via phone (561) 900-6737.

Contact Information

Primary practice address
331 N Deerfield Ave Deerfield Beach FL 33441-2028
Phone: (561) 900-6737
Fax: (954) 422-1726
Website:
Map and Directions
Authorized official contact:
Name: Johnson, Pamela V ARNP
Phone: (561) 900-6737

Health care specialties

SpecialtyCodeLicense #State
Ambulatory Health Care Facilities / Health Service 261QH0100X
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X ARNP2155102 Florida

Profile Details

NPI number 1417085697
LBN Legal business name Ida Wallace Bennett Family Health Corporation
DBA Doing business as Ida Wallace Bennett Family Corporation
Authorized official Johnson, Pamela V ARNP
Entity Organization
Organization subpart 1 No
Enumeration date Mar 1st, 2007
Last updated Jul 16th, 2013 - about 11 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1417085697 NPPES
Florida Other BCBSFL PTAN AK407

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