Didier Mbenza PA-C
Medical Physician Assistant in Lauderdale Lakes, FL(View on Map)
Full Name
Didier Mbenza PA-C
NPI Number
1245587161
NPI Type
Individual Provider
Gender
Male
Enumeration Date
08/09/2012
Specialties
(Taxonomies)Licenses
State
Florida
License Number
PA9106549
Contact
Information
Purpose
Mailing
Location
Address
3500 N STATE ROAD 7
3500 N STATE ROAD 7
City
Lauderdale Lakes
Lauderdale Lakes
State
FL
FL
Postal Code
33319-5600
33319-5600
Country
US
US
Telephone Number
(954) 766-4233
(954) 766-4233
Identifiers
Identifier
PA9106549
Identifier State
FL
Identifier Issuer
PHYSICIAN ASSISTANT LICENSE
Provider data last refreshed from NPPES NPI registry on 11/19/2024
Data last updated by provider on 08/09/2012