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General NPI Number Information
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NPI Number | 1255111852
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Entity Type | Individual
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Provider Name | CHABELI BENITEZ
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Gender | Female
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Dates
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Enumeration Date | 10/02/2023
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Last Update Date | 10/12/2023
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Provider Practice Location Address
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Address Line | 3033 WINKLER AVE UNIT 100
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City | FORT MYERS
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State | FL
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Zip | 33916-9523
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Country | US
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Telephone | 239-277-7070
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Fax |
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Provider Business Mailing Address
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Address Line | 336 SW 24TH PL
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City | CAPE CORAL
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State | FL
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Zip | 33991-1268
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Country | US
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Telephone | 239-321-3170
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA9117877
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License Number State | FL
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