DIDIER MBENZA (NPI# 1245587161) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1245587161 |
| Entity Type | Individual |
| Full Name | DIDIER MBENZA |
| Credential | PA-C |
| Practice Address |
3500 N State Road 7 Suite 211 Lauderdale Lakes FL 33319-5600 |
| Practice Telephone | 9547664233 |
| Practice Fax Number | 9543062056 |
| Mailing Telephone | 9547664233 |
| Mailing Fax Number | 9543062056 |
| Enumeration Date | 2012-08-09 |
| Last Update Date | 2012-08-09 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
PA9106549 | FL | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | PHYSICIAN ASSISTANT LICENSE | PA9106549 | 01 |
| Street Address |
3500 N STATE ROAD 7 SUITE 211 |
| City | LAUDERDALE LAKES |
| State | FL |
| Zip Code | 33319-5600 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508835620 | Prima Home Health LLC | Home Health | 3500 N State Road 7, Suite 499, Lauderdale Lakes, FL 33319-5600 | 2006-03-14 |
| 1992162325 | Victory Chiropractic, Inc. | Chiropractor | 3500 N State Road 7, Ste 480, Lauderdale Lakes, FL 33319-5600 | 2016-01-15 |
| 1639549348 | A Loving Life Care, LLC | In Home Supportive Care | 3500 N State Road 7, Suite 302, Lauderdale Lakes, FL 33319-5600 | 2015-10-07 |
| 1548646086 | Highpoint Healing and Wellness, Inc. | Acupuncturist | 3500 N State Road 7, Suite 405, Lauderdale Lakes, FL 33319-5600 | 2015-08-06 |
| 1023414067 | Josy Enterprises II Inc. | Home Health | 3500 N State Road 7, Suite 304, Lauderdale Lakes, FL 33319-5600 | 2014-11-18 |
| 1417293192 | Atroypen, Inc. | Community/Behavioral Health | 3500 N State Road 7, Suite 408, Lauderdale Lakes, FL 33319-5600 | 2012-12-27 |
| 1629330774 | Tropical Health & Homecare Services, Inc. | Home Health | 3500 N State Road 7, Suite 209, Lauderdale Lakes, FL 33319-5600 | 2012-06-14 |
| 1487942256 | Riva Konoval | Physician Assistant | 3500 N State Road 7, Ste 211, Lauderdale Lakes, FL 33319-5625 | 2011-07-14 |
| 1144511098 | Pamela Bradford | Counselor | 3500 N State Road 7, Lauderdale Lakes, FL 33319-5600 | 2011-04-27 |
| 1750670949 | Selvin Holder | Counselor | 3500 N State Road 7, Ste 211, Lauderdale Lakes, FL 33319-5600 | 2011-03-29 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548876733 | Amerktrans Inc | Non-emergency Medical Transport (VAN) | 7481 W Oakland Blvd, 204 C, Lauderhill, FL 33319 | 2020-09-22 |
| 1285264309 | Kevia Figueroa | Marriage & Family Therapist | 4699 N. State Road 7, Suite B1, Tamarac, FL 33319 | 2020-01-16 |
| 1922640283 | A- Plus Medical and Rehab Center Inc | Family Medicine | 4699 N.state Road 7, Suite B 2, Tamarac, FL 33319 | 2019-10-08 |
| 1538711296 | Center of Hope Healthcare, LLC | Family Medicine | 6879 W Commerical Blvd, Tamarac, FL 33319 | 2019-07-12 |
| 1518430362 | Trinity Urgent Care Corp | Clinic/Center | 5411 North State Road 7, Tamarac, FL 33319 | 2019-01-04 |
| 1073007282 | Monthia Allison Ricketts | Registered Nurse | 5841 Nw 56th Place, Tamarac, FL 33319 | 2018-06-20 |
| 1518454164 | Prudent Pharmacy | Pharmacy | 5575 N State Road 7 Ste B, Lauderdale Lakes, FL 33319 | 2018-04-19 |
| 1831603034 | Kristi Dawn Messer | Social Worker | 7491 West Oakland Park Blvd, Suite 308, Lauderhill, FL 33319 | 2017-11-27 |
| 1356855639 | Metamorphosis Psyche LLC | Clinic/Center | 7051 West Commercial Blvd, Suite 3b, Tamarac, FL 33319 | 2017-11-26 |
| 1730693151 | Patricia Turner | Marriage & Family Therapist | 4699 N. State Rd. 7, B-1, Tamarac, FL 33319 | 2017-11-21 |
| Find all providers in zip 33319 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447540315 | We Care Family Clinic Incorporated | Physician Assistant | 4410-12 W. Oakland Park Blvd., Lauderdale Lakes, FL 33313 | 2011-04-13 |
| 1588640056 | Cybelle Perez Herrera | Physician Assistant | 2957 Nw 27th St, Lauderdale Lakes, FL 33311-2040 | 2005-12-16 |
| 1164822649 | Tiffany Renee Comerie | Physician Assistant | 5000 W Oakland Park Blvd, Lauderdale Lakes, FL 33313-1503 | 2014-09-03 |
| 1497057350 | Johana F Duque | Physician Assistant | 4850 W Oakland Park Blvd, 201, Lauderdale Lakes, FL 33313-7260 | 2010-11-29 |
| 1710963129 | Judith Spring Gallagher | Physician Assistant | 2957 Nw 27th St, Lauderdale Lakes, FL 33311-2040 | 2005-12-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255931325 | Jonathan Thomas Nusbaum | Physician Assistant | 26160 Angelica Rd, Punta Gorda, FL 33955-1419 | 2020-10-28 |
| 1235738659 | Kevin Marcus Luks | Physician Assistant | 10701 Santa Fe Dr, Hollywood, FL 33026-4955 | 2020-10-19 |
| 1245839521 | Stephanie Clay | Physician Assistant | 3455 Rose Mallow Loop, Oviedo, FL 32766-6648 | 2020-10-19 |
| 1104423755 | Lou Joseph Schneggenburger | Physician Assistant | 10115 Forest Hill Blvd Ste 100, Wellington, FL 33414-6178 | 2020-10-07 |
| 1235744582 | Stephanie Graham | Physician Assistant | 1053 Bernice Rd, Rockledge, FL 32955-2201 | 2020-09-14 |
| 1790399483 | Shyla Imani Kissoon | Physician Assistant | 4830 Nw 7th St, Plantation, FL 33317-1410 | 2020-09-01 |
| 1770193500 | My Physician Online | Physician Assistant | 9540 Nw 23rd St, Coral Springs, FL 33065-4974 | 2020-08-06 |
| 1225647977 | Robert Drew Singleton | Physician Assistant | 17501 Biscayne Blvd Ste 460, Aventura, FL 33160-4806 | 2020-07-29 |
| 1750990974 | Andrea K Webber | Physician Assistant | 8119 Sw State Rd 200, Ocala, FL 34481-3448 | 2020-07-23 |
| 1851919526 | Kyra Panni | Physician Assistant | 3857 Hartwood Ln, Jacksonville, FL 32216-1486 | 2020-07-09 |
| Find all providers with the same taxonomy | ||||
| City | LAUDERDALE LAKES |
| Zip Code | 33319 |
Please comment or provide details below to improve the information on DIDIER MBENZA.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.