Most Relevant Information
Provider Data
| NPI Number: | 1003518184 |
| Provider Name: | BENJAMIN ROBERT COOPER DO |
| Entity Type: | Individual |
| Taxonomy Code: | 390200000X |
| Specialty: | Student in an Organized Health Care Education/Training Program |
| License Number: |
Most Important Dates
| Enumeration Date: | 03/21/2023 |
| Last Updated: | 03/21/2023 |
Provider Practice Location
2001 KINGSLEY AVE
ORANGE PARK
FL
320735148
Practice Location Phone/Fax
| Phone: | 9046398500 |
| Fax: |
Provider Mailing Location
2001 KINGSLEY AVE
ORANGE PARK
FL
320735148
Provider Mailing Phone/Fax
| Phone: | 9046398242 |
| Fax: |