Mbenza, Didier

Mbenza, Didier is an sole proprietor health care provider with primary practice located at 3500 N State Road 7 Suite 211, Lauderdale Lakes FL 33319-5600. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Medical, which is considered as his primary health care specialty. Mbenza, Didier can be contacted via phone (954) 766-4233.

Contact Information

Primary practice address
3500 N State Road 7 Suite 211 Lauderdale Lakes FL 33319-5600
Phone: (954) 766-4233
Fax: (954) 306-2056
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Medical 363AM0700X PA9106549 Florida

Profile Details

NPI number 1245587161
LBN Legal business name Mbenza, Didier
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Aug 9th, 2012
Last updated Aug 9th, 2012 - about 13 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 1245587161 NPPES
Florida Other PA9106549 PHYSICIAN ASSISTANT LICENSE

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