Healthcare Provider Details

I. General information

NPI: 1285565242
Provider Name (Legal Business Name): DIANA DENISE BENITEZ
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/28/2026
Last Update Date: 05/28/2026
Certification Date: 05/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

121 NW AVENUE F
BELLE GLADE FL
33430-2618
US

IV. Provider business mailing address

121 NW AVENUE F
BELLE GLADE FL
33430-2618
US

V. Phone/Fax

Practice location:
  • Phone: 561-463-1224
  • Fax:
Mailing address:
  • Phone: 561-463-1224
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License NumberSZ13002
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: