MEDICARE: JOHANNYS ELAINE BENITEZ LUGO

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	183500000X	Pharmacist	70083	FL

General Provider Information

NPI Number	:	1699625335
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOHANNYS ELAINE BENITEZ LUGO

Provider Business Mailing Address
First Line	:	15507 STONEYBROOK WEST PKWY
Second Line	:
City	:	WINTER GARDEN
State	:	FL
Zip	:	34787-4734
Country	:	US
Telephone Number	:	407-905-4044
Fax Number	:

Provider Business Practice Location Address
First Line	:	15507 STONEYBROOK WEST PKWY
Second Line	:
City	:	WINTER GARDEN
State	:	FL
Zip	:	34787-4734
Country	:	US
Telephone Number	:	407-905-4044
Fax Number	:

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

Provider Enumeration Date	:	02/02/2026
Last Update Date	:	02/02/2026

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Directions to “ JOHANNYS ELAINE BENITEZ LUGO ” Practice Location

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