Provider Demographics
NPI:1588665921
Name:LATONI BENEDETTI, MARIA EUGENIA (OD)
Entity Type:Individual
Prefix:DR
First Name:MARIA
Middle Name:EUGENIA
Last Name:LATONI BENEDETTI
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:CALLE 7 L-49 PRADO ALTO
Mailing Address - Street 2:
Mailing Address - City:GUAYNABO
Mailing Address - State:PR
Mailing Address - Zip Code:00966
Mailing Address - Country:US
Mailing Address - Phone:787-792-8625
Mailing Address - Fax:
Practice Address - Street 1:LAS CATALINAS MALL
Practice Address - Street 2:
Practice Address - City:CAGUAS
Practice Address - State:PR
Practice Address - Zip Code:00725-5200
Practice Address - Country:US
Practice Address - Phone:787-744-0470
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-08-09
Last Update Date:2012-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR360152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR56718 LAOtherSSS