Provider Demographics
NPI:1093846875
Name:MARTINEZ-RIVERA, LUIS A (MD)
Entity Type:Individual
Prefix:DR
First Name:LUIS
Middle Name:A
Last Name:MARTINEZ-RIVERA
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:AVE. FELISA RINCON #300
Mailing Address - Street 2:LAS VISTAS SHOPPING CENTER SUITE 43
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00926-2805
Mailing Address - Country:US
Mailing Address - Phone:787-761-5880
Mailing Address - Fax:
Practice Address - Street 1:300 AVE DONA FELISA RINCON DE STE 43
Practice Address - Street 2:300 AVE DONA FELISA RINCON
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00926-5970
Practice Address - Country:US
Practice Address - Phone:787-761-5880
Practice Address - Fax:787-761-5880
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-07
Last Update Date:2023-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR166572083P0500X, 2083P0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083P0500XAllopathic & Osteopathic PhysiciansPreventive MedicinePreventive Medicine/Occupational Environmental Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR16657OtherMEDICAL LICENSE