Provider Demographics
NPI:1548322985
Name:BENTAL, KARYL YARDENA (DO)
Entity type:Individual
Prefix:
First Name:KARYL
Middle Name:YARDENA
Last Name:BENTAL
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:900 S PINE ISLAND RD STE 800
Mailing Address - Street 2:
Mailing Address - City:PLANTATION
Mailing Address - State:FL
Mailing Address - Zip Code:33324-3923
Mailing Address - Country:US
Mailing Address - Phone:772-336-2818
Mailing Address - Fax:772-336-5313
Practice Address - Street 1:1850 SW FOUNTAINVIEW BLVD STE 105
Practice Address - Street 2:
Practice Address - City:PORT SAINT LUCIE
Practice Address - State:FL
Practice Address - Zip Code:34986-4527
Practice Address - Country:US
Practice Address - Phone:772-336-2818
Practice Address - Fax:772-336-5313
Is Sole Proprietor?:No
Enumeration Date:2006-12-14
Last Update Date:2025-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAOP61482874207Q00000X, 208000000X
GA051198208000000X
FLOS19766208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAVAD000Medicare UPIN