Healthcare Provider Details

I. General information

NPI: 1316883341
Provider Name (Legal Business Name): EDELMARY OQUENDO-BENABE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/23/2026
Last Update Date: 04/23/2026
Certification Date: 04/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

ATTN CREDENTIALS 411 OAK ST
CINCINNATI OH
45219
US

IV. Provider business mailing address

ATTN CREDENTIALS 411 OAK ST
CINCINNATI OH
45219
US

V. Phone/Fax

Practice location:
  • Phone: 513-984-1800
  • Fax: 513-984-4909
Mailing address:
  • Phone: 513-984-1800
  • Fax: 513-984-4909

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number75839
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: