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General NPI Number Information
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NPI Number | 1053049015
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Entity Type | Organization
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Legal Business Name | NAPLES FOOT AND ANKLE GROUP PA
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Dates
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Enumeration Date | 08/09/2022
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Last Update Date | 08/31/2022
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Provider Practice Location Address
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Address Line | 3940 RADIO RD STE 104
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City | NAPLES
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State | FL
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Zip | 34104-3740
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Country | US
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Telephone | 239-300-9722
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Fax | 239-399-3816
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Provider Business Mailing Address
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Address Line | 5171 CORAL WOOD DR
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City | NAPLES
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State | FL
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Zip | 34119-1455
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. CAMILO JOSE BENITEZ
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Credential | DPM
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Telephone | 347-581-7018
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number |
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License Number State |
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