Provider Demographics
NPI:1932564077
Name:BENITEZ-ESTEVENZ, JULIA (LAC, LMT)
Entity Type:Individual
Prefix:
First Name:JULIA
Middle Name:
Last Name:BENITEZ-ESTEVENZ
Suffix:
Gender:F
Credentials:LAC, LMT
Other - Prefix:
Other - First Name:JULIA
Other - Middle Name:E
Other - Last Name:BENITEZ
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:10874 CYPRESS GLEN DRIVE
Mailing Address - Street 2:
Mailing Address - City:CORAL SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:33071
Mailing Address - Country:US
Mailing Address - Phone:786-873-9686
Mailing Address - Fax:
Practice Address - Street 1:3000 N UNIVERSITY DR
Practice Address - Street 2:SUITE A
Practice Address - City:CORAL SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:33065-5055
Practice Address - Country:US
Practice Address - Phone:786-873-9686
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-12-16
Last Update Date:2019-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAP3719171100000X
FLMA67900225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
No171100000XOther Service ProvidersAcupuncturist