Provider Demographics
NPI:1811968894
Name:DEL VALLE RODRIGUEZ, BENJAMIN (MD)
Entity type:Individual
Prefix:MR
First Name:BENJAMIN
Middle Name:
Last Name:DEL VALLE RODRIGUEZ
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 1:4000 AVE. LAKE VIEW ESTATES
Mailing Address - Street 2:SUITE 49
Mailing Address - City:CAGUAS Q
Mailing Address - State:PR
Mailing Address - Zip Code:00725-3360
Mailing Address - Country:US
Mailing Address - Phone:787-746-2681
Mailing Address - Fax:787-744-0180
Practice Address - Street 1:CALLE PINTA BF 4 URB BAIROA
Practice Address - Street 2:
Practice Address - City:CAGUAS
Practice Address - State:PR
Practice Address - Zip Code:00725
Practice Address - Country:US
Practice Address - Phone:787-746-2681
Practice Address - Fax:787-744-0180
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR97302084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry