Healthcare Provider Details

I. General information

NPI: 1093640567
Provider Name (Legal Business Name): ALLISON LAUREN BENEZRA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/16/2026
Last Update Date: 06/16/2026
Certification Date: 06/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18260 NE 19TH AVE STE 203C
NORTH MIAMI BEACH FL
33162-1632
US

IV. Provider business mailing address

21210 NE 32ND PL # A
AVENTURA FL
33180-3682
US

V. Phone/Fax

Practice location:
  • Phone: 561-702-6141
  • Fax:
Mailing address:
  • Phone: 786-537-3031
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2355S0801X
TaxonomySpeech-Language Assistant
License Number7658
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: