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General NPI Number Information
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NPI Number | 1083178701
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Entity Type | Individual
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Provider Name | VICTORIA BENAVENTE PT
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Gender | Female
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Dates
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Enumeration Date | 01/27/2019
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Last Update Date | 11/06/2024
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Provider Practice Location Address
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Address Line | 4040 FAIRFAX DR STE 120
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City | ARLINGTON
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State | VA
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Zip | 22203-1613
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Country | US
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Telephone | 571-877-6028
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Fax |
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Provider Business Mailing Address
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Address Line | 4040 FAIRFAX DR STE 120
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City | ARLINGTON
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State | VA
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Zip | 22203-1613
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Country | US
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Telephone | 949-606-3425
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 295909
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 230514763
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License Number State | VA
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Taxonomy #3
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 0016191
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License Number State | CO
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