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General NPI Number Information
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NPI Number | 1407487473
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Entity Type | Individual
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Provider Name | RAMON LAZARO BENITEZ APRN
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Gender | Male
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Dates
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Enumeration Date | 01/29/2020
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Last Update Date | 01/29/2020
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Provider Practice Location Address
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Address Line | 1630 SE 18TH ST STE 602
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City | OCALA
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State | FL
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Zip | 34471-5472
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Country | US
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Telephone | 352-369-0181
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Fax | 352-369-0246
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Provider Business Mailing Address
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Address Line | 4371 VERONICA S SHOEMAKER BLVD
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City | FORT MYERS
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State | FL
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Zip | 33916-2216
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Country | US
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Telephone | 239-274-8200
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | APRN11005909
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License Number State | FL
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