Provider Demographics
NPI:1013913334
Name:RODRIGUEZ-BENITEZ, ERIC N (OD)
Entity Type:Individual
Prefix:DR
First Name:ERIC
Middle Name:N
Last Name:RODRIGUEZ-BENITEZ
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:129 CALLE PANAMA
Mailing Address - Street 2:URB LOS HUCARES
Mailing Address - City:VEGA BAJA
Mailing Address - State:PR
Mailing Address - Zip Code:00693-5825
Mailing Address - Country:US
Mailing Address - Phone:787-970-8105
Mailing Address - Fax:787-970-8115
Practice Address - Street 1:CARR # 2 KM 56.6
Practice Address - Street 2:BO. FLORIDA AFUERA
Practice Address - City:BARCELONETA
Practice Address - State:PR
Practice Address - Zip Code:00617
Practice Address - Country:US
Practice Address - Phone:787-970-8105
Practice Address - Fax:787-970-8115
Is Sole Proprietor?:No
Enumeration Date:2005-06-22
Last Update Date:2011-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR366152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist