Provider Demographics
NPI:1659686178
Name:DE BENEDETTI ZUNINO, MARIA ELENA (MD)
Entity type:Individual
Prefix:DR
First Name:MARIA ELENA
Middle Name:
Last Name:DE BENEDETTI ZUNINO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1575 N RESLER DR STE D
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79912-8002
Mailing Address - Country:US
Mailing Address - Phone:915-271-4569
Mailing Address - Fax:915-351-0086
Practice Address - Street 1:1575 N RESLER DR STE D
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79912-8002
Practice Address - Country:US
Practice Address - Phone:915-271-4569
Practice Address - Fax:915-351-0086
Is Sole Proprietor?:No
Enumeration Date:2010-08-09
Last Update Date:2019-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXR5109207RC0000X, 207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE47066229001Medicaid