Provider Demographics
NPI:1548676596
Name:BENITEZ ORTIZ, YANIRA (MD)
Entity type:Individual
Prefix:
First Name:YANIRA
Middle Name:
Last Name:BENITEZ ORTIZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 9545
Mailing Address - Street 2:
Mailing Address - City:CAGUAS
Mailing Address - State:PR
Mailing Address - Zip Code:00726-9545
Mailing Address - Country:US
Mailing Address - Phone:939-336-7476
Mailing Address - Fax:939-336-7475
Practice Address - Street 1:1728 CALLE SEGRE
Practice Address - Street 2:URB. RIO PIEDRAS HEIGHTS
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00926
Practice Address - Country:US
Practice Address - Phone:393-367-4769
Practice Address - Fax:939-336-7475
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-09
Last Update Date:2021-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR13542208000000X, 207K00000X
PR19679390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & Immunology
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program