Provider Demographics
NPI:1730720657
Name:BENZER, PIA (APRN)
Entity type:Individual
Prefix:
First Name:PIA
Middle Name:
Last Name:BENZER
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:641 LAKE STONE CIR
Mailing Address - Street 2:
Mailing Address - City:PONTE VEDRA BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32082-4342
Mailing Address - Country:US
Mailing Address - Phone:904-481-9372
Mailing Address - Fax:
Practice Address - Street 1:8708 PERIMETER PARK BLVD UNIT C
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32216-6354
Practice Address - Country:US
Practice Address - Phone:904-312-9259
Practice Address - Fax:904-503-7236
Is Sole Proprietor?:Yes
Enumeration Date:2019-10-02
Last Update Date:2022-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11004982363L00000X
FLAPRN11004982363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner