MEDICARE: ANALEE LIZZETTE BENAVIDES MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207QG0300X	Geriatric Medicine (Family Medicine) Physician	38013	OK
2	207RG0300X	Geriatric Medicine (Internal Medicine) Physician	38013	OK
3	207R00000X	Internal Medicine Physician	38013	OK

General Provider Information

NPI Number	:	1467957639
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANALEE LIZZETTE BENAVIDES MD

Provider Business Mailing Address
First Line	:	102 WOODMONT BLVD STE 600
Second Line	:
City	:	NASHVILLE
State	:	TN
Zip	:	37205-5250
Country	:	US
Telephone Number	:	615-314-5257
Fax Number	:

Provider Business Practice Location Address
First Line	:	7317 S WESTERN AVE
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73139-2007
Country	:	US
Telephone Number	:	405-251-8884
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/28/2018
Last Update Date	:	08/25/2021

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