Angel Emanuel Benitez, MD

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

ACN994 Issued in FL

Practice address

1425 Dunn Ave
Daytona Beach, FL 32114-1437

Phone

(386) 323-9600

NPI assigned

Aug 30, 2011

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in PR

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Island Doctors Intrastate LLC

  • Primary Care Clinic/Center
  • Saint Augustine, FL
  • NPI 1568083889
  NPD (past)
• Health Preventive Services, CSP

  • Multi-Specialty Clinic/Center
  • Bayamon, PR
  • NPI 1649572447
  NPD (past)

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

{
    "created_epoch": "1314662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1582502400000",
    "number": "1760763114",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "121 FAIRWAY CT",
            "city": "BUNNELL",
            "state": "FL",
            "postal_code": "321103411",
            "telephone_number": "939-227-0573"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1425 DUNN AVE",
            "city": "DAYTONA BEACH",
            "state": "FL",
            "postal_code": "321141437",
            "telephone_number": "386-323-9600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENITEZ",
        "first_name": "ANGEL",
        "middle_name": "EMANUEL",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-08-30",
        "last_updated": "2020-02-24",
        "certification_date": "2020-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "PR",
            "license": "018283",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "FL",
            "license": "ACN994",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CMS PTAN",
            "identifier": "FN364A",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UPIN",
            "identifier": "18283",
            "state": "PR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sakinah Lamis Bell
• Shaniqua Bell
• Tayah Lynnae Bell, DC
• Cathleen Bellerose
• Guerlyne Bellevue, BCABA
• Kyle Benkel, MD
• Margaret Benko, RN
• Clayton Bennett
• Julie Anne Bennett, DNP-CRNA
• Victoria L Bentley

• General Practice Physician in Daytona Beach, FL
• Providers in Daytona Beach, FL by specialty
• General Practice Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.