Provider Demographics
NPI:1003808742
Name:MARTIN REYES, ELBA ROSA (MD)
Entity Type:Individual
Prefix:
First Name:ELBA
Middle Name:ROSA
Last Name:MARTIN REYES
Suffix:
Gender:F
Credentials:MD
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Other - Credentials:
Mailing Address - Street 1:87 CARRET 20 COND LA ARBOLEDA
Mailing Address - Street 2:APT 1603
Mailing Address - City:GUAYNABO
Mailing Address - State:PR
Mailing Address - Zip Code:00966
Mailing Address - Country:US
Mailing Address - Phone:787-782-4156
Mailing Address - Fax:
Practice Address - Street 1:AVE SAN PATRICIO # 101
Practice Address - Street 2:MARAMAR PLAZA SUITE 1240
Practice Address - City:GUAYNABO
Practice Address - State:PR
Practice Address - Zip Code:00968-4484
Practice Address - Country:US
Practice Address - Phone:787-508-5445
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-08-18
Last Update Date:2016-03-07
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
PR16147207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR16147OtherMEDICAL LISENCE