Provider Demographics
NPI:1285977512
Name:BENITEZ, CAMILO (DPM)
Entity type:Individual
Prefix:DR
First Name:CAMILO
Middle Name:
Last Name:BENITEZ
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5171 CORAL WOOD DR
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34119-1455
Mailing Address - Country:US
Mailing Address - Phone:347-581-7018
Mailing Address - Fax:
Practice Address - Street 1:3940 RADIO RD STE 104
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34104-3740
Practice Address - Country:US
Practice Address - Phone:239-300-9722
Practice Address - Fax:239-399-3816
Is Sole Proprietor?:No
Enumeration Date:2013-04-04
Last Update Date:2022-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY006791213ES0103X
FLPO4280213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery