Provider Demographics
NPI:1073364394
Name:BENACHO PADILLA, ELIER (MD)
Entity type:Individual
Prefix:DR
First Name:ELIER
Middle Name:
Last Name:BENACHO PADILLA
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:361 GREENWAY TRL
Mailing Address - Street 2:
Mailing Address - City:SANTA ROSA BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32459-5589
Mailing Address - Country:US
Mailing Address - Phone:850-892-8015
Mailing Address - Fax:
Practice Address - Street 1:361 GREENWAY TRL
Practice Address - Street 2:
Practice Address - City:SANTA ROSA BEACH
Practice Address - State:FL
Practice Address - Zip Code:32459-5589
Practice Address - Country:US
Practice Address - Phone:850-892-8015
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-27
Last Update Date:2025-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program