JOHNIQUE C BENNETT (NPI# 1538519640) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1538519640 |
| Entity Type | Individual |
| Full Name | JOHNIQUE C BENNETT |
| Credential | M.D. |
| Practice Address |
2300 Park Ave Ste 205 Orange Park FL 32073 |
| Mailing Address |
4205 Belfort Rd Ste 4015 Jacksonville FL 32216-3623 |
| Practice Telephone | 9042720384 |
| Enumeration Date | 2016-06-20 |
| Last Update Date | 2019-07-02 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | ME136292 | FL | Allopathic & Osteopathic Physicians |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 2627 Riverside Ave, Jacksonville, FL 322044712 | 9043087374 | 9043082908 |
| Street Address |
2300 PARK AVE STE 205 |
| City | ORANGE PARK |
| State | FL |
| Zip Code | 32073 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215579990 | Ellen Cooperrider | Social Worker | 2300 Park Ave Ste 205, Orange Park, FL 32073-5573 | 2019-10-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891309423 | Kingsley Endoscopy Center LLC | Clinic/Center | 970 Kingsley Avenue, Orange Park, FL 32073 | 2020-09-01 |
| 1962028688 | Esra Sari | Student in an Organized Health Care Education/Training Program | 2001 Kingsley Avenue., Orange Park Medical Center, Orange Park, FL 32073 | 2020-06-18 |
| 1104441146 | Zeshan Tariq Malik | Student in an Organized Health Care Education/Training Program | 2001 Kingsley Avenue, Office of Graduate Medical Educa, Orange Park, FL 32073 | 2020-06-16 |
| 1902421894 | Ameer Hamza | Student in an Organized Health Care Education/Training Program | 2001, Kingsley Avenue Office of Graduate Medical Educat, Orange Park, FL 32073 | 2020-06-16 |
| 1497378103 | Fawad Ahmed Rashid | Student in an Organized Health Care Education/Training Program | 2001 Kingsley Avenue Office of Graduate Medical Educati, Orange Park, FL 32073 | 2020-05-28 |
| 1477174985 | Hannan Asghar | Student in an Organized Health Care Education/Training Program | Office of Graduate Medical Education 2001 Kingsley, Orange Park, FL 32073 | 2020-05-06 |
| 1902427156 | Emmanuel Iyanuloluwa Morakinyo | Student in an Organized Health Care Education/Training Program | 413 Deer View Avenue, 2001 Kingsley Ave, Orange Park, FL 32073 | 2020-04-29 |
| 1437799327 | Dalande Leger | Behavior Technician | 1563 Kingsley Ave Suite 103, Orange Park, FL 32073 | 2020-01-08 |
| 1215598313 | Mohammad Harisullah Khan | Student in an Organized Health Care Education/Training Program | 2001 Kingsley Ave, Gme Office, Orange Park, FL 32073 | 2019-06-28 |
| 1558927970 | Preetha Kamath | Student in an Organized Health Care Education/Training Program | Orange Park Medical Center, 2001 Kingsley Ave, Orange Park, FL 32073 | 2019-05-10 |
| Find all providers in zip 32073 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811439516 | Baptist Primary Care Inc | Family Medicine | 769 Blanding Blvd, Suite 7, Orange Park, FL 32065-8720 | 2016-11-11 |
| 1275894529 | Stacy Quinn | Family Medicine | 769 Blanding Blvd Ste 7, Orange Park, FL 32065 | 2012-06-04 |
| 1144591249 | David Maynoldi | Family Medicine | 1202 Kingsley Ave, Orange Park, FL 32073-4632 | 2012-01-20 |
| 1710293980 | Ai Belcon | Family Medicine | 1242 Tahoe Ct, Orange Park, FL 32065-6677 | 2010-08-26 |
| 1154502110 | Baptist Primary Care Inc | Family Medicine | 1590 Island Ln, Suite 1, Orange Park, FL 32003-4406 | 2007-11-19 |
| 1265627541 | Gaines C Martin Md Phd Pa | Family Medicine | 1409 Kingsley Ave Ste 9g, Orange Park, FL 32073-4579 | 2007-09-11 |
| 1194854539 | Charles Marshall House Jr. | Family Medicine | 4607 Highway 17 South, Orange Park, FL 32003-7866 | 2007-03-03 |
| 1194851352 | Sharon Lisa Acevedo | Family Medicine | 971 Prairie Dunes Ct, Orange Park, FL 32065-2680 | 2007-02-24 |
| 1568514503 | First Choice Family Practice Pa | Family Medicine | 550 Wells Rd, Suite 17, Orange Park, FL 32073-2969 | 2007-01-18 |
| 1053463075 | Barbara Leigh Cruikshank | Family Medicine | 2300 Park Ave Ste 200, Orange Park, FL 32073-5571 | 2007-01-18 |
| Find all providers in ORANGE PARK | ||||
| City | ORANGE PARK |
| Zip Code | 32073 |
Please comment or provide details below to improve the information on JOHNIQUE C BENNETT.
| 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.