Provider Demographics
NPI:1104123488
Name:ADAMS, BENETTE (NOT APPLICABLE)
Entity type:Individual
Prefix:MS
First Name:BENETTE
Middle Name:
Last Name:ADAMS
Suffix:
Gender:F
Credentials:NOT APPLICABLE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7950 NW 53RD ST STE 337
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33166-4791
Mailing Address - Country:US
Mailing Address - Phone:786-709-3410
Mailing Address - Fax:305-691-5672
Practice Address - Street 1:7950 NW 53RD ST STE 337
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33166-4791
Practice Address - Country:US
Practice Address - Phone:954-627-4601
Practice Address - Fax:305-691-5672
Is Sole Proprietor?:Yes
Enumeration Date:2011-02-22
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL0290372600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes372600000XNursing Service Related ProvidersAdult Companion