Individual
DR. WANDA I BENITEZ LOPEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
QUINTAS DE SANTA MARIA, 715, MAYAGUEZ, PR 00682-7496
(787) 265-2471
Mailing address
QUINTAS DE SANTA MARIA, 715, MAYAGUEZ, PR 00682-7496
(787) 265-2471
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
6863
PR
2085R0202X
Diagnostic Radiology Physician
R3810
AR
2085R0202X
Diagnostic Radiology Physician
R6E72
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
89084
SSS
—
Enumeration date
12/28/2006
Last updated
05/03/2013
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