Individual provider Active NPI

Lafonda Denmark Beneby

  • Physical Therapist
  • Pembroke Pines, FL
National Provider Identifier
1033397971
Registry record updated Apr 30, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT17043 Issued in FL
Practice address
17796 SW 2ND St
Pembroke Pines, FL 33029-3923
Phone
(954) 438-7800
NPI assigned
Feb 1, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 30, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT17043 FL Primary

Addresses

Primary practice location

17796 SW 2ND St
Pembroke Pines, FL 33029-3923

Mailing address

3350 SW 148TH Ave Ste 110
Miramar, FL 33027-3237
Phone (754) 256-4705

Other identifiers 1

IdentifierTypeStateIssuer
889471000MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
PT17043FLMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Therapy in Motion PA Physical Therapist Current Accepting new patients

Locations

3350 SW 148th Ave
Ste 110
Miramar, FL 33027
Phone (786) 346-9021

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1201824000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1682812800000",
    "number": "1033397971",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3350 SW 148TH AVE STE 110",
            "city": "MIRAMAR",
            "state": "FL",
            "postal_code": "330273237",
            "telephone_number": "754-256-4705"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17796 SW 2ND ST",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330293923",
            "telephone_number": "954-438-7800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENEBY",
        "first_name": "LAFONDA",
        "middle_name": "DENMARK",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-02-01",
        "last_updated": "2023-04-30",
        "certification_date": "2023-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT17043",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "889471000",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pembroke Pines, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.