Basic Information
| Provider Information | |||||||||
| NPI: | 1457585259 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BENEFIELD | ||||||||
| FirstName: | ANDREW | ||||||||
| MiddleName: | DAVID | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 655 W. EIGHTH ST. BOX C506 | ||||||||
| Address2: | CLINICAL CENTER, 1ST FLOOR | ||||||||
| City: | JACKSONVILLE | ||||||||
| State: | FL | ||||||||
| PostalCode: | 32209 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9042443837 | ||||||||
| FaxNumber: | 9042444508 | ||||||||
| Practice Location | |||||||||
| Address1: | 655 W. EIGHTH ST. | ||||||||
| Address2: | CLINICAL CENTER, 1ST FLOOR | ||||||||
| City: | JACKSONVILLE | ||||||||
| State: | FL | ||||||||
| PostalCode: | 32209 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9042443837 | ||||||||
| FaxNumber: | 9042444508 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/07/2009 | ||||||||
| LastUpdateDate: | 03/18/2015 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207P00000X | TRN13445 | FL | Y | Allopathic & Osteopathic Physicians | Emergency Medicine | 207P00000X | ME116742 | FL | N | Allopathic & Osteopathic Physicians | Emergency Medicine | 207P00000X | 068364 | GA | N | Allopathic & Osteopathic Physicians | Emergency Medicine |
No ID Information.