Individual provider Active NPI

Elier Benacho Padilla, MD

  • Student in an Organized Health Care Education/Training Program
  • Santa Rosa Beach, FL
National Provider Identifier
1073364394
Registry record updated Jul 29, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
License
TRN39335 Issued in FL
Practice address
361 Greenway TRL
Santa Rosa Beach, FL 32459-5589
Phone
(850) 892-8015
NPI assigned
Mar 27, 2024
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 29, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X TRN39335 FL Primary
Family Medicine Physician 207Q00000X ME183019 FL
Family Medicine Physician 207Q00000X FB7206786 FL

Addresses

Primary practice location

361 Greenway TRL
Santa Rosa Beach, FL 32459-5589

Mailing address

361 Greenway TRL
Santa Rosa Beach, FL 32459-5589
Phone (850) 892-8015

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250611002139 FL Order and Referring Only - Family PracticePractitioner - Family Practice 5890205579

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Clinical Practice Association Inc Family Medicine PastSince Mar 1, 2024 Accepting new patients
Walton County Health Department PastSince Apr 20, 2025 Accepting new patients

Organizations & group practices 2

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": "1711497600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785283200000",
    "number": "1073364394",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "361 GREENWAY TRL",
            "city": "SANTA ROSA BEACH",
            "state": "FL",
            "postal_code": "324595589",
            "telephone_number": "850-892-8015"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "361 GREENWAY TRL",
            "city": "SANTA ROSA BEACH",
            "state": "FL",
            "postal_code": "324595589",
            "telephone_number": "850-892-8015"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENACHO PADILLA",
        "first_name": "ELIER",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-03-27",
        "last_updated": "2026-07-29",
        "certification_date": "2026-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "FL",
            "license": "TRN39335",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME183019",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "FB7206786",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Rosa Beach, FL

Sources for this page

Verify at the official NPI Registry.