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General NPI Number Information
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NPI Number | 1518587609
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Entity Type | Individual
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Provider Name | CARLOS ENRIQUE CONTRERAS BENITEZ APRN
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Gender | Male
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Dates
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Enumeration Date | 04/20/2020
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Last Update Date | 10/03/2024
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Provider Practice Location Address
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Address Line | 21 S CHARLES RICHARD BEALL BLVD
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City | DEBARY
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State | FL
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Zip | 32713-3332
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Country | US
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Telephone | 386-516-0930
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Fax | 386-668-6897
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Provider Business Mailing Address
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Address Line | 425 W COLONIAL DR STE 303
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City | ORLANDO
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State | FL
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Zip | 32804-6863
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Country | US
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Telephone | 210-630-2207
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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 | APRN11034874
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | NJDCATEMP-007787
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License Number State | NJ
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