Provider Demographics
NPI:1720738131
Name:BENINCORE ROBLEDO, ANDRES (MD)
Entity Type:Individual
Prefix:DR
First Name:ANDRES
Middle Name:
Last Name:BENINCORE ROBLEDO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1201 N CHERRY ST
Mailing Address - Street 2:
Mailing Address - City:TULARE
Mailing Address - State:CA
Mailing Address - Zip Code:93274-2233
Mailing Address - Country:US
Mailing Address - Phone:559-631-4042
Mailing Address - Fax:559-366-7060
Practice Address - Street 1:1186 LELAND AVE
Practice Address - Street 2:
Practice Address - City:TULARE
Practice Address - State:CA
Practice Address - Zip Code:93274-7811
Practice Address - Country:US
Practice Address - Phone:559-686-9097
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-03-28
Last Update Date:2022-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAP4208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics