Organization
DR. JORGE A. BENAVENTE OPTOMETRIST PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JORGE ADAME BENAVENTE OD (PRESIDENT)
(219) 836-7800
Entity
Organization
Contact information
Practice address
9175 CALUMET AVENUE, MUNSTER, IN 46321-2805
(219) 836-7800
(219) 836-4806
Mailing address
9175 CALUMET AVE, MUNSTER, IN 46321-2805
(219) 836-7800
(219) 836-4806
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201033420A
—
IN
Enumeration date
11/18/2009
Last updated
02/28/2025
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