Provider Demographics
NPI:1205540010
Name:CDT DIAGNOSTIX LLC
Entity type:Organization
Organization Name:CDT DIAGNOSTIX LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:LUIS
Authorized Official - Middle Name:M
Authorized Official - Last Name:BENALCAZAR-PUGA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:201-463-8004
Mailing Address - Street 1:P.O. BOX 142
Mailing Address - Street 2:
Mailing Address - City:AGUADILLA
Mailing Address - State:PR
Mailing Address - Zip Code:00605
Mailing Address - Country:US
Mailing Address - Phone:201-463-8004
Mailing Address - Fax:201-464-2519
Practice Address - Street 1:185 CALLE PROGRESO
Practice Address - Street 2:
Practice Address - City:AGUADILLA
Practice Address - State:PR
Practice Address - Zip Code:00603-4802
Practice Address - Country:US
Practice Address - Phone:787-882-1070
Practice Address - Fax:787-882-1070
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-06
Last Update Date:2025-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty