Provider Demographics
NPI:1053401570
Name:RIOS BENITEZ, MARTA IVETTE (MD)
Entity type:Individual
Prefix:DR
First Name:MARTA IVETTE
Middle Name:
Last Name:RIOS BENITEZ
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:EDF PORRATA PILA
Mailing Address - Street 2:2431 BLVD LUIS A FERRER STE 302
Mailing Address - City:PONCE
Mailing Address - State:PR
Mailing Address - Zip Code:00717
Mailing Address - Country:US
Mailing Address - Phone:787-813-6658
Mailing Address - Fax:787-813-6688
Practice Address - Street 1:EDF PORRATA PILA
Practice Address - Street 2:2431 BLVD LUIS A FERRER STE 302
Practice Address - City:PONCE
Practice Address - State:PR
Practice Address - Zip Code:00717
Practice Address - Country:US
Practice Address - Phone:787-813-6658
Practice Address - Fax:787-813-6688
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-13
Last Update Date:2022-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR8790207RC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR0083981Medicare ID - Type Unspecified
PRG16503Medicare UPIN