Provider Demographics
NPI:1003100066
Name:BENCOMO, ROSABEL MARIA (MD)
Entity Type:Individual
Prefix:
First Name:ROSABEL
Middle Name:MARIA
Last Name:BENCOMO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6840 SW 40TH ST STE 209
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33155-3756
Mailing Address - Country:US
Mailing Address - Phone:786-222-8807
Mailing Address - Fax:305-763-8379
Practice Address - Street 1:6840 SW 40TH ST STE 209
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33155-3756
Practice Address - Country:US
Practice Address - Phone:786-222-8807
Practice Address - Fax:305-763-8379
Is Sole Proprietor?:No
Enumeration Date:2011-06-07
Last Update Date:2020-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME119272207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine