Individual
DR. BENTON ROBERT MARINO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
6517 SPANISH FORT BLVD, NEW ORLEANS, LA 70124-4321
(504) 283-7306
Mailing address
6517 SPANISH FORT BLVD, NEW OLREANS, LA 70124-2429
(504) 283-7306
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
MD.205530
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
04484201
—
MS
05
—
2313444
—
LA
Enumeration date
08/08/2007
Last updated
01/11/2022
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