Individual
MARIA JOSE BENINCASA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O
Contact information
Practice address
3340 TAMIAMI TRL, PORT CHARLOTTE, FL 33952-8088
(941) 764-5858
Mailing address
2675 WINKLER AVE FL 2, FORT MYERS, FL 33901-9342
(877) 856-3774
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
OS12947
FL
207RI0011X
Interventional Cardiology Physician
Primary
OS12947
FL
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/11/2013
Last updated
05/05/2023
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