Individual provider Active NPI

Wilfrido Antonio Benitez, MD

  • Family Medicine Physician
  • Hialeah, FL
National Provider Identifier
1629026695
Registry record updated Jul 30, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
ME0068516 Issued in FL
Practice address
686 E 49TH St
Hialeah, FL 33013-1964
Phone
(305) 696-7921
Fax
(305) 688-9671
NPI assigned
May 4, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 30, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X ME0068516 FL Primary

Addresses

Primary practice location

686 E 49TH St
Hialeah, FL 33013-1964

Mailing address

521 Raven Ave
Miami Springs, FL 33166-3950
Phone (305) 696-7921

Other identifiers 1

IdentifierTypeStateIssuer
378278600MedicaidFL

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
I20100528000618 FL Practitioner - General Practice 3678602604 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Practice
Education
Other, 1976
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1435 W 49TH PL
Suite 401
Hialeah, FL 33012-3147
Phone (305) 696-7921

686 E 49TH St
Hialeah, FL 33013-1964
Phone (305) 696-7921

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Physicians Group Inc CurrentSince Nov 2, 2009 Accepting new patients
Florida Physicians Group Inc CurrentSince Nov 2, 2009 Accepting new patients
Personal Care Medical Center Inc Family Medicine Past Accepting new patients

Locations

686 E 49th St
Hialeah, FL 33013
Phone (305) 696-7921

1435 W 49th Pl
Ste 401
Hialeah, FL 33012
Phone (305) 696-7921

4305 E 8th Ave
Hialeah, FL 33013
Phone (305) 688-6484

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1146700800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1596067200000",
    "number": "1629026695",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "521 RAVEN AVE",
            "city": "MIAMI SPRINGS",
            "state": "FL",
            "postal_code": "331663950",
            "telephone_number": "305-696-7921",
            "fax_number": "305-688-9671"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "686 E 49TH ST",
            "city": "HIALEAH",
            "state": "FL",
            "postal_code": "330131964",
            "telephone_number": "305-696-7921",
            "fax_number": "305-688-9671"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENITEZ",
        "first_name": "WILFRIDO",
        "middle_name": "ANTONIO",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-04",
        "last_updated": "2020-07-30",
        "certification_date": "2020-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME0068516",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "378278600",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hialeah, FL

Sources for this page

Verify at the official NPI Registry.