Provider Demographics
NPI:1184803157
Name:KATON-BENITEZ, IVA JOYCE (PA)
Entity type:Individual
Prefix:MRS
First Name:IVA
Middle Name:JOYCE
Last Name:KATON-BENITEZ
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Gender:F
Credentials:PA
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Mailing Address - Street 1:SOUTH ATLANTA MEDICAL ASSOCIATES, PC
Mailing Address - Street 2:1029 CLEVELAND AVENUE
Mailing Address - City:EAST POINT
Mailing Address - State:GA
Mailing Address - Zip Code:30344-6719
Mailing Address - Country:US
Mailing Address - Phone:404-768-4626
Mailing Address - Fax:404-768-4631
Practice Address - Street 1:SOUTH ATLANTA MEDICAL ASSOCIATES, PC
Practice Address - Street 2:1029 CLEVELAND AVENUE
Practice Address - City:EAST POINT
Practice Address - State:GA
Practice Address - Zip Code:30344-6719
Practice Address - Country:US
Practice Address - Phone:404-768-4626
Practice Address - Fax:404-768-4631
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-26
Last Update Date:2019-01-04
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Provider Licenses
StateLicense IDTaxonomies
GA002038363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical