Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208000000X | Pediatrician | ME99106 | FL |
NPI | 1003894494 |
---|---|
Provider Name | Oscar J Benavides |
First Address | Plantation, FL 33324-3920 |
Second Address | Hialeah, FL 33012-3337 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 05/01/2006 |
Last Update Date | 27/03/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
280926500 | (05) | FL |
8438319 | (05) | WA |
I41549 | (02) |