Provider Demographics
NPI:1043316185
Name:CORBEN PHYSICIANS P.S.C.
Entity type:Organization
Organization Name:CORBEN PHYSICIANS P.S.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ERIKA
Authorized Official - Middle Name:MICHELLE
Authorized Official - Last Name:BENABE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-644-5230
Mailing Address - Street 1:B1 CALLE TOMAS AGRAIT
Mailing Address - Street 2:CLUB MANOR VILLAGE
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00924-4350
Mailing Address - Country:US
Mailing Address - Phone:787-757-7956
Mailing Address - Fax:
Practice Address - Street 1:B1 CALLE TOMAS AGRAIT
Practice Address - Street 2:CLUB MANOR VILLAGE
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00924-4350
Practice Address - Country:US
Practice Address - Phone:787-757-7956
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-16
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency MedicineGroup - Multi-Specialty