Provider Demographics
NPI:1447567193
Name:ADOLFO BENITEZ, MD, PA
Entity Type:Organization
Organization Name:ADOLFO BENITEZ, MD, PA
Other - Org Name:FAMILY MEDICINE AND SKIN CARE CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ADOLFO
Authorized Official - Middle Name:LEON
Authorized Official - Last Name:BENITEZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:915-504-6900
Mailing Address - Street 1:3570 RICH BEEM
Mailing Address - Street 2:SUITE A
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79938-3331
Mailing Address - Country:US
Mailing Address - Phone:915-504-6900
Mailing Address - Fax:915-856-1612
Practice Address - Street 1:3570 RICH BEEM
Practice Address - Street 2:STE A
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79938-7993
Practice Address - Country:US
Practice Address - Phone:915-504-6900
Practice Address - Fax:915-856-1612
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-09-01
Last Update Date:2023-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXN7523207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty