Provider Demographics
NPI:1093125338
Name:STATE OF THE ART PLASTIC SURGERY
Entity type:Organization
Organization Name:STATE OF THE ART PLASTIC SURGERY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:KARIM
Authorized Official - Middle Name:
Authorized Official - Last Name:BENITEZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-620-4070
Mailing Address - Street 1:AVE SAN PATRICIO # 101
Mailing Address - Street 2:SUITE 850
Mailing Address - City:GUAYNABO
Mailing Address - State:PR
Mailing Address - Zip Code:00968-4459
Mailing Address - Country:US
Mailing Address - Phone:787-620-4070
Mailing Address - Fax:
Practice Address - Street 1:AVE SAN PATRICIO # 101
Practice Address - Street 2:SUITE 850
Practice Address - City:GUAYNABO
Practice Address - State:PR
Practice Address - Zip Code:00968-4459
Practice Address - Country:US
Practice Address - Phone:787-620-4070
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-05-07
Last Update Date:2014-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR12277208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic SurgeryGroup - Single Specialty