Individual
DR. ANGEL EMANUEL BENITEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1425 DUNN AVE, DAYTONA BEACH, FL 32114-1437
(386) 323-9600
Mailing address
121 FAIRWAY CT, BUNNELL, FL 32110-3411
(939) 227-0573
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
018283
PR
208D00000X
General Practice Physician
Primary
ACN994
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
18283
UPIN
PR
01
—
FN364A
CMS PTAN
—
Enumeration date
08/30/2011
Last updated
02/24/2020
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