Healthcare Provider Details

I. General information

NPI: 1548106701
Provider Name (Legal Business Name): AIMARA BENITEZ SIDDIQUI
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/28/2026
Last Update Date: 04/28/2026
Certification Date: 04/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15380 SW 20TH LN
MIAMI FL
33185-5729
US

IV. Provider business mailing address

15380 SW 20TH LN
MIAMI FL
33185-5729
US

V. Phone/Fax

Practice location:
  • Phone: 305-924-5546
  • Fax: 305-924-5546
Mailing address:
  • Phone: 305-924-5546
  • Fax: 305-924-5546

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number2026020263
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: