Provider Demographics
NPI:1306413059
Name:BARRANTES, BENJAMIN LEVI (DPT)
Entity Type:Individual
Prefix:DR
First Name:BENJAMIN
Middle Name:LEVI
Last Name:BARRANTES
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4324 E BERKELEY RD
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85008-4087
Mailing Address - Country:US
Mailing Address - Phone:602-592-0940
Mailing Address - Fax:
Practice Address - Street 1:10050 N SCOTTSDALE RD STE 111
Practice Address - Street 2:
Practice Address - City:PARADISE VALLEY
Practice Address - State:AZ
Practice Address - Zip Code:85253-1498
Practice Address - Country:US
Practice Address - Phone:602-592-0940
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-09
Last Update Date:2021-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ31809225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist