MEDICARE: MELANY BENAVIDES NP

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	363LF0000X	Family Nurse Practitioner	AP129539	TX

General Provider Information

NPI Number	:	1942666078
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MELANY BENAVIDES NP

Provider Business Mailing Address
First Line	:	2542 CENTRAL PALM DR STE 207
Second Line	:
City	:	RIO GRANDE CITY
State	:	TX
Zip	:	78582-6766
Country	:	US
Telephone Number	:	956-352-1344
Fax Number	:	956-352-1343

Provider Business Practice Location Address
First Line	:	2542 CENTRAL PALM DR STE 207
Second Line	:
City	:	RIO GRANDE CITY
State	:	TX
Zip	:	78582-6766
Country	:	US
Telephone Number	:	956-352-1344
Fax Number	:	956-437-1343

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

Provider Enumeration Date	:	01/05/2016
Last Update Date	:	03/23/2021

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