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General NPI Number Information
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NPI Number | 1962420984
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Entity Type | Individual
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Provider Name | JULIO EDGARDO BENABE M.D.
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Gender | Male
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Dates
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Enumeration Date | 07/17/2006
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Last Update Date | 11/20/2015
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Provider Practice Location Address
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Address Line | CONSORCIO DE INVESTIGACION CLINICAS RCM ESCUELA DE MEDICINA CENTRO MEDICO DE PUERTO RICO
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City | SAN JUAN
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State | PR
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Zip | 00935
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Country | US
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Telephone | 787-759-0306
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Fax | 787-759-0305
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Provider Business Mailing Address
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Address Line | 6165 AVE. ISLA VERDE ESJ TOWERS APT 1474
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City | CAROLINA
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State | PR
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Zip | 00979
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Country | US
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Telephone | 787-759-0306
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Fax | 787-759-0305
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RN0300X
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Taxonomy Name | Nephrology Physician
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License Number | #6123
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License Number State | PR
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