Individual
FERNANDO BENITEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2121 1ST ST, WHITE BEAR LAKE, MN 55110-3413
(651) 338-8247
Mailing address
2121 1ST ST, WHITE BEAR LAKE, MN 55110-3413
(651) 338-8247
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
—
MN
Other
Enumeration date
02/10/2022
Last updated
02/10/2022
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