MEDICARE: DR. KARIM BENITEZ-MARCHAND M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	174400000X	Specialist	12277	PR

General Provider Information

NPI Number	:	1801888490
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KARIM BENITEZ-MARCHAND M.D.

Provider Business Mailing Address
First Line	:	1353 AVE LUIS VIGOREAUX
Second Line	:	PMB 530
City	:	GUAYNABO
State	:	PR
Zip	:	00966-2715
Country	:	US
Telephone Number	:	787-721-5102
Fax Number	:	787-977-0300

Provider Business Practice Location Address
First Line	:	ASHFORD MEDICAL CTR
Second Line	:	29 WASHINGTON ST. SUITE 805
City	:	SAN JUAN
State	:	PR
Zip	:	00907-1510
Country	:	US
Telephone Number	:	787-721-5102
Fax Number	:	787-977-0300

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/18/2005
Last Update Date	:	07/08/2007

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