Healthcare Provider Details

I. General information

NPI: 1932706470
Provider Name (Legal Business Name): JOANN BENALLOUN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/07/2020
Last Update Date: 01/05/2026
Certification Date: 01/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1120 NW 14TH ST FL 5
MIAMI FL
33136-2107
US

IV. Provider business mailing address

2111 SOLE MIA WAY
NORTH MIAMI FL
33181-2492
US

V. Phone/Fax

Practice location:
  • Phone: 305-243-2000
  • Fax:
Mailing address:
  • Phone: 305-243-3773
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberAPRN11009577
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: