Provider Demographics
NPI:1811562390
Name:BENITES MOYA, CESAR JOEL (MD)
Entity Type:Individual
Prefix:MR
First Name:CESAR JOEL
Middle Name:
Last Name:BENITES MOYA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:655 W 8TH ST FL CENTER5
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32209-6511
Mailing Address - Country:US
Mailing Address - Phone:909-244-3932
Mailing Address - Fax:
Practice Address - Street 1:1400 PELHAM PARKWAY SOUTH
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10461
Practice Address - Country:US
Practice Address - Phone:718-918-5642
Practice Address - Fax:718-918-3174
Is Sole Proprietor?:No
Enumeration Date:2021-05-26
Last Update Date:2024-03-22
Deactivation Date:2022-11-23
Deactivation Code:
Reactivation Date:2024-03-21
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program