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General NPI Number Information
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NPI Number | 1669706297
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Entity Type | Individual
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Provider Name | OSCAR BENITEZ DOMINGUEZ CBHCMS, APRN
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Gender | Male
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Dates
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Enumeration Date | 09/30/2009
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Last Update Date | 03/31/2023
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Provider Practice Location Address
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Address Line | 2750 W 68TH ST # 127-128
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City | HIALEAH
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State | FL
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Zip | 33016-5446
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Country | US
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Telephone | 305-558-0765
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Fax | 305-558-0768
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Provider Business Mailing Address
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Address Line | 224 NW 20TH ST
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City | HOMESTEAD
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State | FL
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Zip | 33030-3117
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Country | US
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Telephone | 786-370-8755
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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 | 104100000X
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Taxonomy Name | Social Worker
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | APRN11025243
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License Number State | FL
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