Provider Demographics
NPI:1861095002
Name:BENEDIKT, RONNY (RPH)
Entity type:Individual
Prefix:
First Name:RONNY
Middle Name:
Last Name:BENEDIKT
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7621 N STATE ROAD 7
Mailing Address - Street 2:
Mailing Address - City:PARKLAND
Mailing Address - State:FL
Mailing Address - Zip Code:33073-3504
Mailing Address - Country:US
Mailing Address - Phone:954-341-3338
Mailing Address - Fax:954-341-3389
Practice Address - Street 1:7621 N STATE ROAD 7
Practice Address - Street 2:
Practice Address - City:PARKLAND
Practice Address - State:FL
Practice Address - Zip Code:33073-3504
Practice Address - Country:US
Practice Address - Phone:954-341-3338
Practice Address - Fax:954-341-3389
Is Sole Proprietor?:No
Enumeration Date:2020-11-19
Last Update Date:2020-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS018194183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL018194OtherPHARMACIST