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Individual

JOSE LUIS BENITEZ

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
170 DRAPER AVE, NORTH ATTLEBORO, MA 02760-3604
(508) 695-9421
(508) 695-1341
Mailing address
170 DRAPER AVE, NORTH ATTLEBORO, MA 02760-3604
(508) 695-9421
(508) 695-1341

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
241352
MA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
110082636A
MA
01
AA153514
HPHC
MA
01
J46314
BCBS MA
MA
Enumeration date
03/02/2007
Last updated
11/30/2011
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