Provider Demographics
NPI:1134103187
Name:BENITEZ, MARITZA (MD)
Entity Type:Individual
Prefix:
First Name:MARITZA
Middle Name:
Last Name:BENITEZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 115
Mailing Address - Street 2:HDS LA MONSERRATE
Mailing Address - City:MANATI
Mailing Address - State:PR
Mailing Address - Zip Code:00674-0115
Mailing Address - Country:US
Mailing Address - Phone:787-854-5976
Mailing Address - Fax:787-862-7646
Practice Address - Street 1:TORRE MEDICA 1
Practice Address - Street 2:DOCTORS CENTER HOSPITAL OFICINA 306
Practice Address - City:MANATI
Practice Address - State:PR
Practice Address - Zip Code:00674
Practice Address - Country:US
Practice Address - Phone:787-884-9697
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-12-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR7732208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
066893OtherCRUZ AZUL
80384BEOtherTRIPLE S