Basic Information
| Provider Information | |||||||||
| NPI: | 1053375949 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BENAVIDES | ||||||||
| FirstName: | LORENA | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2304 WESVILL CT | ||||||||
| Address2: | SUITE 210 | ||||||||
| City: | RALEIGH | ||||||||
| State: | NC | ||||||||
| PostalCode: | 276070058 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9197826700 | ||||||||
| FaxNumber: | 9197822218 | ||||||||
| Practice Location | |||||||||
| Address1: | 2304 WESVILL CT | ||||||||
| Address2: | SUITE 210 | ||||||||
| City: | RALEIGH | ||||||||
| State: | NC | ||||||||
| PostalCode: | 276070058 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9197826700 | ||||||||
| FaxNumber: | 9197822218 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/17/2006 | ||||||||
| LastUpdateDate: | 08/17/2016 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207VG0400X | 2006-00441 | NC | Y | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology | Gynecology |
No ID Information.