Healthcare Provider Details

I. General information

NPI: 1497922132
Provider Name (Legal Business Name): GHIZLANE BENCHEKROUNE M.D
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/12/2008
Last Update Date: 12/17/2025
Certification Date: 12/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7560 RED BUG LAKE RD STE 1070
OVIEDO FL
32765-6591
US

IV. Provider business mailing address

101 SERENE HILLTOP CIR
LAKEWAY TX
78738-1231
US

V. Phone/Fax

Practice location:
  • Phone: 407-366-4040
  • Fax:
Mailing address:
  • Phone: 646-421-7630
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberME178198
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number0033971
License Number StateNY
# 3
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberP2592
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: