Provider Demographics
NPI:1598587727
Name:DE LEON BENITEZ, ROXANA DE LA CARIDAD
Entity type:Individual
Prefix:
First Name:ROXANA DE LA CARIDAD
Middle Name:
Last Name:DE LEON BENITEZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16981 SW 297TH ST
Mailing Address - Street 2:
Mailing Address - City:HOMESTEAD
Mailing Address - State:FL
Mailing Address - Zip Code:33030-3406
Mailing Address - Country:US
Mailing Address - Phone:786-255-3136
Mailing Address - Fax:
Practice Address - Street 1:16981 SW 297TH ST
Practice Address - Street 2:
Practice Address - City:HOMESTEAD
Practice Address - State:FL
Practice Address - Zip Code:33030-3406
Practice Address - Country:US
Practice Address - Phone:786-255-3136
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-29
Last Update Date:2024-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician