Individual
MR. ELDIS BENITEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1400 NE 125TH ST, NORTH MIAMI, FL 33161-6034
(305) 915-8900
(866) 599-2563
Mailing address
1025 W 23RD ST, HIALEAH, FL 33010-1921
(786) 915-2606
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
CCM101522-A
FL
Other
Enumeration date
12/12/2017
Last updated
12/12/2017
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