Healthcare Provider Details

I. General information

NPI: 1164423315
Provider Name (Legal Business Name): CESAR L BENARROCHE MD PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/09/2005
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7301A W PALMETTO PARK RD SUITE 106-C
BOCA RATON FL
33433-3409
US

IV. Provider business mailing address

7301A W PALMETTO PARK RD SUITE 106-C
BOCA RATON FL
33433-3409
US

V. Phone/Fax

Practice location:
  • Phone: 561-391-4669
  • Fax: 561-391-1815
Mailing address:
  • Phone: 561-391-4669
  • Fax: 561-391-1815

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberME 0048762
License Number StateFL

VIII. Authorized Official

Name: CESAR L BENARROCHE
Title or Position: PRESIDENT
Credential: MD
Phone: 561-391-4669