Provider Demographics
NPI:1003499807
Name:BENITEZ DANGER, MONICA SONIA
Entity Type:Individual
Prefix:
First Name:MONICA
Middle Name:SONIA
Last Name:BENITEZ DANGER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20819 SW 118TH AVE
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33177-7014
Mailing Address - Country:US
Mailing Address - Phone:786-553-5382
Mailing Address - Fax:
Practice Address - Street 1:13500 SW 88TH ST STE 285
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33186-1515
Practice Address - Country:US
Practice Address - Phone:786-409-2646
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-30
Last Update Date:2021-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-20-137473106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician