Provider Demographics
NPI:1366334849
Name:BUZON BENITEZ, VLADIMIR
Entity type:Individual
Prefix:
First Name:VLADIMIR
Middle Name:
Last Name:BUZON BENITEZ
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5857 HAYES ST
Mailing Address - Street 2:
Mailing Address - City:HOLLYWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:33021-5168
Mailing Address - Country:US
Mailing Address - Phone:954-997-0990
Mailing Address - Fax:
Practice Address - Street 1:5857 HAYES ST
Practice Address - Street 2:
Practice Address - City:HOLLYWOOD
Practice Address - State:FL
Practice Address - Zip Code:33021-5168
Practice Address - Country:US
Practice Address - Phone:954-997-0990
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-17
Last Update Date:2025-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-25-451830106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician