Provider Demographics
NPI:1952848277
Name:BENITEZ, VANESSA (MSW)
Entity Type:Individual
Prefix:
First Name:VANESSA
Middle Name:
Last Name:BENITEZ
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2501 BRICKELL AVE APT 1004
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33129-2461
Mailing Address - Country:US
Mailing Address - Phone:305-283-1909
Mailing Address - Fax:
Practice Address - Street 1:9075 SW 87TH AVE
Practice Address - Street 2:SUITE # 412
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33176-2308
Practice Address - Country:US
Practice Address - Phone:305-283-1909
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-01-24
Last Update Date:2017-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLISW 75881041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical