Provider Demographics
NPI:1962875195
Name:BENITEZ, DOMINGO ERNESTO (ARNP)
Entity type:Individual
Prefix:
First Name:DOMINGO
Middle Name:ERNESTO
Last Name:BENITEZ
Suffix:
Gender:M
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5101 SW 8TH STREET
Mailing Address - Street 2:SUITE 200
Mailing Address - City:CORAL GABLES
Mailing Address - State:FL
Mailing Address - Zip Code:33134-2442
Mailing Address - Country:US
Mailing Address - Phone:305-359-5037
Mailing Address - Fax:786-509-5544
Practice Address - Street 1:5101 SW 8TH STREET
Practice Address - Street 2:SUITE 200
Practice Address - City:CORAL GABLES
Practice Address - State:FL
Practice Address - Zip Code:33134-2442
Practice Address - Country:US
Practice Address - Phone:305-262-6060
Practice Address - Fax:305-262-6038
Is Sole Proprietor?:Yes
Enumeration Date:2015-11-10
Last Update Date:2025-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9388821363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
0131652OtherBOARD CERTIFICATION
0131652OtherCERTIFICATION