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General NPI Number Information
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NPI Number | 1922808153
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Entity Type | Organization
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Legal Business Name | BENESSERE SPECIALTY MEDICAL GROUP LLCP
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Dates
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Enumeration Date | 03/17/2025
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Last Update Date | 09/15/2025
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Provider Practice Location Address
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Address Line | 790 NW 107TH AVE STE 301
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City | MIAMI
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State | FL
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Zip | 33172-3160
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Country | US
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Telephone | 305-392-0968
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Fax | 786-953-6559
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Provider Business Mailing Address
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Address Line | 790 NW 107TH AVE STE 301
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City | MIAMI
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State | FL
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Zip | 33172-3160
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Country | US
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Telephone | 305-392-0968
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Fax | 786-953-6559
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Authorized Official
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Title or Position | OWNER
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Name | CARLOS DIAZ
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Credential | PA
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Telephone | 786-506-1786
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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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 | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 207RE0101X
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Taxonomy Name | Endocrinology, Diabetes & Metabolism Physician
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 207RI0011X
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Taxonomy Name | Interventional Cardiology Physician
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License Number |
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License Number State |
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