Active NPI
Miguel Alfonso Benitez, R.N.
- Registered Nurse
- Fresno, CA
National Provider Identifier
1073872537
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Nurse
- License
- 53611
- Practice address
- 4411 E Kings Canyon
Fresno, CA 93706 - Phone
- (559) 512-8335
- NPI assigned
- May 3, 2012
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 53611 | CA | Primary |
Addresses
Primary practice location
4411 E Kings Canyon
Fresno, CA 93706
Mailing address
2583 Roberts Ave.
Clovis, CA 93611
Phone (559) 312-7520
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
- Credentials
- Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 53611 | CA | MD | Marriage & Family Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1336003200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1336003200000",
"number": "1073872537",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2583 ROBERTS AVE.",
"city": "CLOVIS",
"state": "CA",
"postal_code": "93611",
"telephone_number": "559-312-7520"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4411 E KINGS CANYON",
"city": "FRESNO",
"state": "CA",
"postal_code": "93706",
"telephone_number": "559-512-8335"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BENITEZ",
"first_name": "MIGUEL",
"middle_name": "ALFONSO",
"credential": "R.N.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2012-05-03",
"last_updated": "2012-05-03",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "CA",
"license": "53611",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fresno, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.