Provider Demographics
NPI:1477906253
Name:BENITEZ, VERONICA (PSYD)
Entity Type:Individual
Prefix:DR
First Name:VERONICA
Middle Name:
Last Name:BENITEZ
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13940 SW 136TH ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33186-5541
Mailing Address - Country:US
Mailing Address - Phone:305-399-7104
Mailing Address - Fax:305-235-5271
Practice Address - Street 1:13940 SW 136TH ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33186-5541
Practice Address - Country:US
Practice Address - Phone:305-399-7104
Practice Address - Fax:305-235-5271
Is Sole Proprietor?:Yes
Enumeration Date:2016-07-18
Last Update Date:2016-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY9378103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical