Basic Information
| Provider Information | |||||||||
| NPI: | 1972584878 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | BENITEZ APONTE | ||||||||
| FirstName: | JOSE | ||||||||
| MiddleName: | L | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | BENITEZ | ||||||||
| OtherFirstName: | JOSE | ||||||||
| OtherMiddleName: | L | ||||||||
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| OtherCredential: | |||||||||
| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | PO BOX 489 | ||||||||
| Address2: | |||||||||
| City: | HUMACAO | ||||||||
| State: | PR | ||||||||
| PostalCode: | 007920489 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7878526825 | ||||||||
| FaxNumber: | 7878505005 | ||||||||
| Practice Location | |||||||||
| Address1: | 15 PADRE RIVERA ST | ||||||||
| Address2: | |||||||||
| City: | HUMACAO | ||||||||
| State: | PR | ||||||||
| PostalCode: | 00791 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7878526825 | ||||||||
| FaxNumber: | 7878505005 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/08/2005 | ||||||||
| LastUpdateDate: | 12/01/2016 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207W00000X | 8744 | PR | Y | Allopathic & Osteopathic Physicians | Ophthalmology |
No ID Information.