Healthcare Provider Details

I. General information

NPI: 1689596405
Provider Name (Legal Business Name): ADRIANA C BENITEZ OD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/27/2026
Last Update Date: 07/27/2026
Certification Date: 07/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9655 S DIXIE HWY STE 202
PINECREST FL
33156-2813
US

IV. Provider business mailing address

11105 SW 128TH CT
MIAMI FL
33186-4707
US

V. Phone/Fax

Practice location:
  • Phone: 786-558-7295
  • Fax:
Mailing address:
  • Phone: 786-400-0275
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number6948
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: