| Type | Person | [sources] | |||
|---|---|---|---|---|---|
| Name | JOHNNY CLYDE JR BENJAMIN · Johnny Clyde Benjamin Jr. | [sources] | |||
| Birth date | [sources] | ||||
| Nationality | not available | [sources] | |||
| Country | United States | [sources] | |||
| First name | Johnny | [sources] | |||
| ID Number | MD050488L (PA) | [sources] | |||
| Last name | Benjamin | [sources] | |||
| Middle name | CLYDE JR · Clyde | [sources] | |||
| NPI | 1265464168 | [sources] | |||
| Title | MD | [sources] | |||
| Position | SURGERY (PHYSICIAN (MD, DO)) | [sources] | |||
| Address | (FL), (FL) · P O BOX 1033, #16689-104, COLEMAN, FL 33521 | [sources] | |||
| Last change | Last processed | First seen | |||
Medical providers who are precluded from participation in the Medical Assistance Program
United States · DHS
People and companies excluded from Federally funded health care programs
United States · OIG
us-fed-excl-johnny-clyde-jr-benjamin-33521-coleman · us-medpa-fcccdb162e092665dae2c8c096a20b869ecdbe06For experts: raw data explorer
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| Sanctions | |||||
|---|---|---|---|---|---|
| Country | Authority | Program | Start date | End date | |
| United States | Department of Health and Human Services Office of Inspector General | - | |||
| Address | ||
|---|---|---|
| Full address | Country | |
| (FL), (FL) · (FL.), (FL.) · FL, FL | United States | |
| United States | Department of Human Services | - | - |