Individual provider · NPI-1

Maria Jose Benincasa, D.O

Internal Medicine, Interventional Cardiology · Port Charlotte, FL

NPI number1427399849

StatusActive

Last updated in NPPESMay 5, 2023

Details

NPI: 1427399849
Entity type: Individual (NPI-1)
Name: Maria Jose Benincasa
Credential: D.O
Sex: Female
Sole proprietor: No
Enumeration date: Mar 11, 2013
Certification date: May 5, 2023
Last updated: May 5, 2023

Taxonomy and licenses

Taxonomy code	Description	License	State	Primary
207RI0011X	Internal Medicine, Interventional Cardiology	OS12947	FL	Yes
207Q00000X	Family Medicine	OS12947	FL
390200000X	Student in an Organized Health Care Education/Training Program	–	–

Practice location

3340 Tamiami Trl
Port Charlotte, FL 33952-8088

Phone 941-764-5858

Mailing address

2675 Winkler Ave Fl 2
Fort Myers, FL 33901-9342

Phone 877-856-3774

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