# BENITEZ MD SUPPLY CORP

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1104580703
- **Authorized official:** JOSE R VALDEZ (PRESIDENT)
- **Authorized official phone:** (786) 592-1173

## Contact information

- **Practice address:** 12150 SW 128TH CT, MIAMI, FL 33186-4647
- **Practice address phone:** (786) 592-1173
- **Mailing address:** 12150 SW 128TH CT, MIAMI, FL 33186-4647

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 332B00000X | Durable Medical Equipment & Medical Supplies | — | NULL | Yes |

## Other

- **Enumeration date:** 10/29/2021
- **Last updated:** 03/23/2022