Provider Demographics
NPI:1700028099
Name:BENITEZ, NIXALYZ ORTIZ (FNP - BC)
Entity Type:Individual
Prefix:
First Name:NIXALYZ
Middle Name:ORTIZ
Last Name:BENITEZ
Suffix:
Gender:F
Credentials:FNP - BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4490 PORTOFINO WAY
Mailing Address - Street 2:APT. 112
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33409-8100
Mailing Address - Country:US
Mailing Address - Phone:305-962-6559
Mailing Address - Fax:
Practice Address - Street 1:3599 W HILLSBORO BLVD
Practice Address - Street 2:
Practice Address - City:DEERFIELD BEACH
Practice Address - State:FL
Practice Address - Zip Code:33442-9404
Practice Address - Country:US
Practice Address - Phone:954-333-5214
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-04-01
Last Update Date:2015-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR144887363LF0000X
FLARNP9417992363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily