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Individual

DR. JOHN G BENITEZ

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD, MPH

Contact information

Practice address
3551 ROGER BROOKE DR, FORT SAM HOUSTON, TX 78234-4504
(585) 245-3911
Mailing address
3551 ROGER BROOKE DR, FORT SAM HOUSTON, TX 78234-4504

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
19701
TN
207P00000X
Emergency Medicine Physician
219852
NY
207PT0002X
Medical Toxicology (Emergency Medicine) Physician
219852
NY
2083P0500X
Preventive Medicine/Occupational Environmental Medicine Physician
219852
NY
2083T0002X
Medical Toxicology (Preventive Medicine) Physician
Primary
19701
TN
2083X0100X
Occupational Medicine Physician
19701
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
02136010
NY
Enumeration date
07/17/2006
Last updated
09/15/2020
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