Provider Demographics
NPI:1861683807
Name:BENAVIDES, CARMEN MARIA (BS)
Entity Type:Individual
Prefix:
First Name:CARMEN
Middle Name:MARIA
Last Name:BENAVIDES
Suffix:
Gender:F
Credentials:BS
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:7510 SW 153RD PL APT 203
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33193-1726
Mailing Address - Country:US
Mailing Address - Phone:305-364-5533
Mailing Address - Fax:786-332-2919
Practice Address - Street 1:14750 SW 26TH ST
Practice Address - Street 2:SUITE: 209
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33185-5933
Practice Address - Country:US
Practice Address - Phone:305-364-5533
Practice Address - Fax:786-332-2919
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-06
Last Update Date:2012-12-28
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist