Konynenbelt, Benjamin John

Konynenbelt, Benjamin John is an individual health care provider with primary practice located at 2551 Drew St , Clearwater FL 33765-2839. He recently has 2 registered licenses in different health care specialties including Eye and Vision Services Providers / Vision Therapy, Eye and Vision Services Providers / Optometrist. Eye and Vision Services Providers / Optometrist is his primary health care specialty. Konynenbelt, Benjamin John can be contacted via phone (727) 791-1214.

Contact Information

Primary practice address
2551 Drew St Clearwater FL 33765-2839
Fax: (844) 766-9698
Website:

Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Vision Therapy 152WV0400X 3237 Tennessee
Eye and Vision Services Providers / Optometrist 152W00000X OPC5272 Florida

Profile Details

NPI number 1114300472
LBN Legal business name Konynenbelt, Benjamin John
Credentials Doctor of Optometry (OD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 6th, 2015
Last updated Jul 21st, 2022 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1114300472 NPPES
Florida MEDICAID 019087700

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