Provider Demographics
NPI:1760664718
Name:BENNETT, AVONNY CADECIA CHRISTEEN (PMHNP-BC,CRNA)
Entity type:Individual
Prefix:
First Name:AVONNY
Middle Name:CADECIA CHRISTEEN
Last Name:BENNETT
Suffix:
Gender:F
Credentials:PMHNP-BC,CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:382 NE 191ST ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33179-3899
Mailing Address - Country:US
Mailing Address - Phone:561-250-7660
Mailing Address - Fax:561-709-8935
Practice Address - Street 1:382 NE 191ST ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33179-3899
Practice Address - Country:US
Practice Address - Phone:561-250-7660
Practice Address - Fax:561-709-8935
Is Sole Proprietor?:No
Enumeration Date:2007-12-02
Last Update Date:2025-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN9170652367500000X, 363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
No363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLG4530OtherBCBS
FL3091261 00Medicaid
FL3091261 00Medicaid
FLAK260XMedicare PIN