Individual
LUIS IVAN ROSA BENIQUE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
BO NARANJO CARR 417 R 4415 KM 3.6, AGUADA, PR 00602
(939) 288-8145
Mailing address
HC- 56 BOX 46772, AGUADA, PR 00602
(939) 288-8145
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
22852
PR
Other
Enumeration date
10/25/2019
Last updated
08/23/2022
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