Provider Demographics
NPI:1073594404
Name:MARTINEZ, EDILBERTO (MD)
Entity Type:Individual
Prefix:
First Name:EDILBERTO
Middle Name:
Last Name:MARTINEZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:73 CALLE SANTA CRUZ
Mailing Address - Street 2:EDIF. MEDICO SANTA CRUZ SUITE 413
Mailing Address - City:BAYAMON
Mailing Address - State:PR
Mailing Address - Zip Code:00961-6910
Mailing Address - Country:US
Mailing Address - Phone:787-269-1445
Mailing Address - Fax:787-787-2808
Practice Address - Street 1:73 CALLE SANTA CRUZ
Practice Address - Street 2:EDIF. MEDICO SANTA CRUZ SUITE 413
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00961-6910
Practice Address - Country:US
Practice Address - Phone:787-269-1445
Practice Address - Fax:787-787-2808
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-11
Last Update Date:2013-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR13733207VM0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VM0101XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyMaternal & Fetal Medicine