Provider Demographics
NPI:1063757110
Name:BENITEZ, JESSICA DEL CARMEN
Entity type:Individual
Prefix:
First Name:JESSICA
Middle Name:DEL CARMEN
Last Name: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 1:1901 TREETOP LN APT 43
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20904-6627
Mailing Address - Country:US
Mailing Address - Phone:240-755-6045
Mailing Address - Fax:
Practice Address - Street 1:1901 TREETOP LN APT 43
Practice Address - Street 2:
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20904-6627
Practice Address - Country:US
Practice Address - Phone:240-755-6045
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-11-30
Last Update Date:2025-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCHHA11133374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide