MEDICARE: ANIXIA DE LOS ANGELES BENAVIDES MARTINEZ

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	APRN11029095	FL

General Provider Information

NPI Number	:	1205691342
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANIXIA DE LOS ANGELES BENAVIDES MARTINEZ

Provider Business Mailing Address
First Line	:	3014 CORAL WAY # CU7
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33145-3208
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3014 SW 22ND ST
Second Line	:
City	:	CORAL GABLES
State	:	FL
Zip	:	33145-3208
Country	:	US
Telephone Number	:	305-529-9975
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/19/2024
Last Update Date	:	02/19/2024

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