Provider Demographics
NPI:1427153246
Name:LATONI BENEDETTI, ALMA (OD)
Entity type:Individual
Prefix:DR
First Name:ALMA
Middle Name:
Last Name:LATONI BENEDETTI
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:URB. PUNTA LAS MARIAS
Mailing Address - Street 2:27 CALLE CAOBA
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00913-4720
Mailing Address - Country:US
Mailing Address - Phone:787-224-4521
Mailing Address - Fax:
Practice Address - Street 1:CENTRO GRAN CARIBE MALL
Practice Address - Street 2:
Practice Address - City:VEGA ALTA
Practice Address - State:PR
Practice Address - Zip Code:00692
Practice Address - Country:US
Practice Address - Phone:787-883-1414
Practice Address - Fax:787-883-1414
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-14
Last Update Date:2020-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR120152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PRV-06618Medicare UPIN
PR5-6719Medicare ID - Type Unspecified