Individual provider Active NPI

Elizabeth Benitez, MD

  • Pediatrics Physician
  • Newberry, FL
National Provider Identifier
1083659387
Registry record updated Nov 19, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
ME75288 Issued in FL
Practice address
215 NW 138TH Ter
Suite 100
Newberry, FL 32669-2090
Phone
(352) 332-2345
Fax
(352) 332-2394
NPI assigned
Jun 19, 2006
Last updated
Nov 19, 2012By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 19, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X ME75288 FL
Pediatrics Physician 208000000X ME75288 FL Primary

Addresses

Primary practice location

215 NW 138TH Ter
Suite 100
Newberry, FL 32669-2090

Mailing address

215 NW 138TH Ter
Suite 100
Newberry, FL 32669-2090
Phone (352) 332-2345

Other identifiers 1

IdentifierTypeStateIssuer
256212000MedicaidFL

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
I20100917000305 FL Practitioner - Pediatric Medicine 1052436789 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME75288FLMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Clinical Practice Association Inc CurrentSince Jun 6, 2010 Accepting new patients
Florida Clinical Practice Association Inc CurrentSince Jun 6, 2010 Accepting new patients
Dr. B's Kids, PA Pediatrics PastSince May 17, 2020 Accepting new patients

Locations

1600 SW Archer Rd
Gainesville, FL 32610
Phone (352) 265-0077

2001 SW 13th St
Gainesville, FL 32608
Phone (352) 265-8990

Organizations & group practices 3

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

NPI Registry JSON

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

{
    "created_epoch": "1150675200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1353283200000",
    "number": "1083659387",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "215 NW 138TH TER",
            "address_2": "SUITE 100",
            "city": "NEWBERRY",
            "state": "FL",
            "postal_code": "326692090",
            "telephone_number": "352-332-2345",
            "fax_number": "352-332-2394"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "215 NW 138TH TER",
            "address_2": "SUITE 100",
            "city": "NEWBERRY",
            "state": "FL",
            "postal_code": "326692090",
            "telephone_number": "352-332-2345",
            "fax_number": "352-332-2394"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENITEZ",
        "first_name": "ELIZABETH",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-06-19",
        "last_updated": "2012-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "FL",
            "license": "ME75288",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "FL",
            "license": "ME75288",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "256212000",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Newberry, FL

Sources for this page

Verify at the official NPI Registry.