Provider Demographics
NPI:1558054239
Name:A. BENAVIDES THERAPY LLC
Entity Type:Organization
Organization Name:A. BENAVIDES THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUTHORIZED OFFICIAL
Authorized Official - Prefix:
Authorized Official - First Name:ALICIA
Authorized Official - Middle Name:E
Authorized Official - Last Name:FALCON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-255-7892
Mailing Address - Street 1:303 TIMBERLANE CIR
Mailing Address - Street 2:
Mailing Address - City:GREENACRES
Mailing Address - State:FL
Mailing Address - Zip Code:33463-8405
Mailing Address - Country:US
Mailing Address - Phone:561-255-7892
Mailing Address - Fax:
Practice Address - Street 1:303 TIMBERLANE CIR
Practice Address - Street 2:
Practice Address - City:GREENACRES
Practice Address - State:FL
Practice Address - Zip Code:33463-8405
Practice Address - Country:US
Practice Address - Phone:561-255-7892
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-30
Last Update Date:2023-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental TherapistGroup - Single Specialty