Provider Demographics
NPI:1164423315
Name:CESAR L BENARROCHE MD PA
Entity Type:Organization
Organization Name:CESAR L BENARROCHE MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CESAR
Authorized Official - Middle Name:L
Authorized Official - Last Name:BENARROCHE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:561-391-4669
Mailing Address - Street 1:7301A W PALMETTO PARK RD
Mailing Address - Street 2:SUITE 106-C
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33433-3409
Mailing Address - Country:US
Mailing Address - Phone:561-391-4669
Mailing Address - Fax:561-391-1815
Practice Address - Street 1:7301A W PALMETTO PARK RD
Practice Address - Street 2:SUITE 106-C
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33433-3409
Practice Address - Country:US
Practice Address - Phone:561-391-4669
Practice Address - Fax:561-391-1815
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-08-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME 0048762101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
D20755Medicare UPIN
02589AMedicare ID - Type Unspecified