Vanbennekom, Jason L.

Vanbennekom, Jason L. is an individual health care provider with primary practice located at 400 Colonnade Dr Ste 230 , Ponte Vedra FL 32081-6237. He recently has only one registered license in Allopathic & Osteopathic Physicians / Obstetrics & Gynecology, which is considered as his primary health care specialty. Vanbennekom, Jason L. can be contacted via phone (904) 640-8249.

Contact Information

Primary practice address
400 Colonnade Dr Ste 230 Ponte Vedra FL 32081-6237
Phone: (904) 640-8249
Fax: (904) 640-8250
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Obstetrics & Gynecology 207V00000X ME93647 Florida

Profile Details

NPI number 1720040983
LBN Legal business name Vanbennekom, Jason L.
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 4th, 2006
Last updated Jun 23rd, 2023 - about 2 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 1720040983 NPPES
Florida MEDICAID 273136300

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