Provider Demographics
NPI:1356108914
Name:BENITEZ PALOMINO, MELANY
Entity type:Individual
Prefix:
First Name:MELANY
Middle Name:
Last Name:BENITEZ PALOMINO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:406 NE 13TH PL
Mailing Address - Street 2:
Mailing Address - City:CAPE CORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33909-2146
Mailing Address - Country:US
Mailing Address - Phone:239-355-9736
Mailing Address - Fax:
Practice Address - Street 1:406 NE 13TH PL
Practice Address - Street 2:
Practice Address - City:CAPE CORAL
Practice Address - State:FL
Practice Address - Zip Code:33909-2146
Practice Address - Country:US
Practice Address - Phone:239-355-9736
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-29
Last Update Date:2024-02-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician