Provider Demographics
NPI:1255319380
Name:VARELA FERNANDEZ, BENIGNO L (MD)
Entity Type:Individual
Prefix:MR
First Name:BENIGNO
Middle Name:L
Last Name:VARELA FERNANDEZ
Suffix:
Gender:M
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 363986
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00936-3986
Mailing Address - Country:US
Mailing Address - Phone:787-751-0373
Mailing Address - Fax:787-751-5577
Practice Address - Street 1:AVE PONCE DE LEON 735
Practice Address - Street 2:COND. TORRE AUXILLIO MUTUO, STE 416
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00977
Practice Address - Country:US
Practice Address - Phone:787-751-0373
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR6441207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
97855Medicare ID - Type Unspecified
D26669Medicare UPIN