MEDICARE: AVONNY CADECIA CHRISTEEN BENNETT PMHNP-BC,CRNA

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	367500000X	Certified Registered Nurse Anesthetist	APRN9170652	FL
2	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	APRN9170652	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	G4530	OTHER	FL	BCBS
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1760664718
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AVONNY CADECIA CHRISTEEN BENNETT PMHNP-BC,CRNA

Provider Business Mailing Address
First Line	:	382 NE 191ST ST
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33179-3899
Country	:	US
Telephone Number	:	561-250-7660
Fax Number	:	561-709-8935

Provider Business Practice Location Address
First Line	:	382 NE 191ST ST
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33179-3899
Country	:	US
Telephone Number	:	561-250-7660
Fax Number	:	561-709-8935

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

Provider Enumeration Date	:	12/02/2007
Last Update Date	:	09/30/2025

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