Provider Demographics
NPI:1275345126
Name:RODRIGUEZ BENITEZ, KAIRA (DC)
Entity type:Individual
Prefix:
First Name:KAIRA
Middle Name:
Last Name:RODRIGUEZ BENITEZ
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:335 CENTRAL STATE BLVD
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46222-0105
Mailing Address - Country:US
Mailing Address - Phone:939-401-3861
Mailing Address - Fax:
Practice Address - Street 1:5637 W 56TH ST
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46254-1652
Practice Address - Country:US
Practice Address - Phone:317-401-9555
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-27
Last Update Date:2025-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN08003495A111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor