Ivonne I Benabe Huertas

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

12328 Issued in PR

Practice address

J6 Calle 2
Brisas del Mar
Luquillo, PR 00773-2471

Phone

(787) 376-5415

Fax

(787) 889-7001

NPI assigned

Apr 10, 2007

Last updated

Mar 22, 2012By the provider in NPPES

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in PR

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1176163200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1332374400000",
    "number": "1083837025",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 875",
            "city": "LUQUILLO",
            "state": "PR",
            "postal_code": "007730875",
            "telephone_number": "787-376-5415",
            "fax_number": "787-889-7001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "J6 CALLE 2",
            "address_2": "BRISAS DEL MAR",
            "city": "LUQUILLO",
            "state": "PR",
            "postal_code": "007732471",
            "telephone_number": "787-376-5415",
            "fax_number": "787-889-7001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENABE HUERTAS",
        "first_name": "IVONNE",
        "middle_name": "I",
        "name_prefix": "Dr.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-04-10",
        "last_updated": "2012-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "PR",
            "license": "12328",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cristobal Antron Avila, M.D
• Ana M Avillan, CRNA
• Axel A Ayala
• Jose Antonio Barreras, MD
• Sissi Michelle Barreto, MD
• Manuel Betancourt Torres, M.D
• Egnis Betancourt, PHD
• Anthony Bristol Rodriguez, MSN
• C.a. Group Services LLC (C.A. Group Services LLC - Luquillo)
• Amanda Caban Herrera

• General Practice Physician in Luquillo, PR
• Providers in Luquillo, PR by specialty
• General Practice Physician in Puerto Rico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.