Individual provider Active NPI

Jorge Benitez, APRN

  • Family Nurse Practitioner
  • Wilton Manors, FL
National Provider Identifier
1629619796
Registry record updated Jul 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
11003538 Issued in FL
Practice address
2097 Wilton Dr
Wilton Manors, FL 33305-2121
Phone
(877) 259-8727
NPI assigned
Sep 30, 2019
Last updated
Jul 30, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 30, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 11003538 FL Primary

Addresses

Primary practice location

2097 Wilton Dr
Wilton Manors, FL 33305-2121

Mailing address

6255 W Sunset Blvd FL 21
Los Angeles, CA 90028-7422
Phone (323) 860-5200

Other practice location 1

2833 NW 68th Ln
Margate, FL 33063-2041
Phone (786) 715-6293

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200311000429 FL Practitioner - Nurse Practitioner 2466536131 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
AIDS Healthcare FoundationGroup PAC ID 2668369109, 101 clinicians

Practice addresses (Care Compare)

2097 Wilton Dr
Wilton Manors, FL 33305-2121
Phone (877) 259-8727

3135 State Rd
Suite 1
Safety Harbor, FL 34695-4917
Phone (727) 725-9931

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
11003538FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Abg Professional Health Services Inc. Current Accepting new patients
Guidewell Sanitas I, LLC CurrentSince Dec 9, 2019 Accepting new patients
AIDS Healthcare Foundation Current Accepting new patients
AIDS Healthcare Foundation CurrentSince Apr 30, 2024 Accepting new patients
AIDS Healthcare Foundation CurrentSince Apr 30, 2024 Accepting new patients

Locations

6255 W Sunset Blvd
Fl 21
Los Angeles, CA 90028
Phone (323) 860-5200

8400 NW 33rd St
Ste 201
Doral, FL 33122
Phone (786) 882-2869

180 SW 84th Ave
Plantation, FL 33324
Phone (954) 271-2855

3135 State Road 580
Ste 1
Safety Harbor, FL 34695
Phone (727) 259-2000

3617 W Hillsborough Ave
Tampa, FL 33614
Phone (813) 675-2020

2097 Wilton Dr
Wilton Manors, FL 33305
Phone (877) 259-8727

Interoperability endpoints

  • Direct secure messaging: jorge.benitez.1@26356.direct.athenahealth.com
  • Direct secure messaging: jorge.benitez@wwmp.eclinicaldirectplus.com

Organizations & group practices 5

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": "1569801600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722297600000",
    "number": "1629619796",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6255 W SUNSET BLVD FL 21",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900287422",
            "telephone_number": "323-860-5200",
            "fax_number": "323-467-7119"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2097 WILTON DR",
            "city": "WILTON MANORS",
            "state": "FL",
            "postal_code": "333052121",
            "telephone_number": "877-259-8727"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2833 NW 68th Ln",
            "address_purpose": "LOCATION",
            "city": "Margate",
            "state": "FL",
            "postal_code": "330632041",
            "country_code": "US",
            "telephone_number": "786-715-6293",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BENITEZ",
        "first_name": "JORGE",
        "name_prefix": "Mr.",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-09-30",
        "last_updated": "2024-07-30",
        "certification_date": "2024-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "11003538",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilton Manors, FL

Sources for this page

Verify at the official NPI Registry.