Provider Demographics
NPI:1073965372
Name:MARTINEZ GONZALEZ, JOSE (RN)
Entity Type:Individual
Prefix:
First Name:JOSE
Middle Name:
Last Name:MARTINEZ GONZALEZ
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 739
Mailing Address - Street 2:
Mailing Address - City:CIDRA
Mailing Address - State:PR
Mailing Address - Zip Code:00739-0739
Mailing Address - Country:US
Mailing Address - Phone:787-739-4861
Mailing Address - Fax:787-735-3233
Practice Address - Street 1:206 CALLE SAN JUSTO
Practice Address - Street 2:
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00901-1711
Practice Address - Country:US
Practice Address - Phone:787-739-4861
Practice Address - Fax:787-735-3233
Is Sole Proprietor?:No
Enumeration Date:2016-07-11
Last Update Date:2016-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR74969163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse