Healthcare Provider Details

I. General information

NPI: 1669302816
Provider Name (Legal Business Name): GRETTER BENITEZ MD PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/20/2026
Last Update Date: 05/20/2026
Certification Date: 05/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14791 OAK LN
MIAMI LAKES FL
33016-1518
US

IV. Provider business mailing address

14791 OAK LN
MIAMI LAKES FL
33016-1518
US

V. Phone/Fax

Practice location:
  • Phone: 305-330-9977
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. GRETTER BENITEZ
Title or Position: CEO
Credential: MD
Phone: 305-967-2594