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General NPI Number Information
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NPI Number | 1982582862
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Entity Type | Individual
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Provider Name | KIMBERLY BENITEZ
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Gender | Female
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Dates
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Enumeration Date | 08/26/2025
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Last Update Date | 08/26/2025
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Provider Practice Location Address
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Address Line | 770 LIGHTHOUSE DR STE 110
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City | BARNEGAT
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State | NJ
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Zip | 08005-2499
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Country | US
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Telephone | 609-891-2781
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Fax |
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Provider Business Mailing Address
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Address Line | 41 15TH ST
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City | TOMS RIVER
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State | NJ
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Zip | 08753-2429
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Country | US
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Telephone | 732-598-2893
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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 | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | 26NJ15390200
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License Number State | NJ
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