1518587609 NPI number — CARLOS ENRIQUE CONTRERAS BENITEZ APRN

Table of content: MRS. HELGA REGINA FLOYD FNP-BC (NPI 1376183251)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1518587609 NPI number — CARLOS ENRIQUE CONTRERAS BENITEZ APRN

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
CONTRERAS BENITEZ
Provider First Name:
CARLOS
Provider Middle Name:
ENRIQUE
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
APRN
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1518587609
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
10/03/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
425 W COLONIAL DR STE 303
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ORLANDO
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
32804-6863
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
210-630-2207
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
21 S CHARLES RICHARD BEALL BLVD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
DEBARY
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
32713-3332
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
386-516-0930
Provider Business Practice Location Address Fax Number:
386-668-6897
Provider Enumeration Date:
04/20/2020

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363LF0000X , with the licence number:  APRN11034874 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 208D00000X , with the licence number: NJDCATEMP-007787 , registered in the state of NJ ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)





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