Provider Demographics
NPI:1255320792
Name:INTERMED OB GYN GROUP
Entity Type:Organization
Organization Name:INTERMED OB GYN GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:AURELIO
Authorized Official - Middle Name:
Authorized Official - Last Name:BENES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-746-5454
Mailing Address - Street 1:PO BOX 7379
Mailing Address - Street 2:
Mailing Address - City:CAGUAS
Mailing Address - State:PR
Mailing Address - Zip Code:00726-7379
Mailing Address - Country:US
Mailing Address - Phone:787-746-5454
Mailing Address - Fax:787-746-5455
Practice Address - Street 1:STE 108 AVE MUNIZ MARIN
Practice Address - Street 2:ESQ DEGATAU
Practice Address - City:CAQUAS
Practice Address - State:PR
Practice Address - Zip Code:00725
Practice Address - Country:US
Practice Address - Phone:787-746-5454
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-18
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty