Provider Demographics
NPI:1649411885
Name:LUIS LOPEZ-BENITEZ MD LTD
Entity Type:Organization
Organization Name:LUIS LOPEZ-BENITEZ MD LTD
Other - Org Name:CENTENNIAL OB/GYN
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:LUIS
Authorized Official - Middle Name:J
Authorized Official - Last Name:LOPEZ-BENITEZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:702-476-1100
Mailing Address - Street 1:6850 N DURANGO DR
Mailing Address - Street 2:SUITE 420
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89149-4595
Mailing Address - Country:US
Mailing Address - Phone:702-476-1100
Mailing Address - Fax:702-476-1101
Practice Address - Street 1:6850 N DURANGO DR
Practice Address - Street 2:SUITE 420
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89149-4595
Practice Address - Country:US
Practice Address - Phone:702-476-1100
Practice Address - Fax:702-476-1101
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-03-18
Last Update Date:2011-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV12325207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV1891992780OtherINDIVIDUAL NPI