Provider Demographics
NPI:1114963436
Name:MARTINEZ, CARY ZOE (MD)
Entity Type:Individual
Prefix:DR
First Name:CARY
Middle Name:ZOE
Last Name:MARTINEZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:CARY
Other - Middle Name:ZOE
Other - Last Name:MARTINEZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:199 CALLE RIO LA PLATA
Mailing Address - Street 2:
Mailing Address - City:HUMACAO
Mailing Address - State:PR
Mailing Address - Zip Code:00791-4446
Mailing Address - Country:US
Mailing Address - Phone:787-285-1076
Mailing Address - Fax:787-285-1076
Practice Address - Street 1:199 CALLE RIO LA PLATA
Practice Address - Street 2:
Practice Address - City:HUMACAO
Practice Address - State:PR
Practice Address - Zip Code:00791-4446
Practice Address - Country:US
Practice Address - Phone:787-285-1076
Practice Address - Fax:787-285-1076
Is Sole Proprietor?:No
Enumeration Date:2006-06-22
Last Update Date:2012-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR9958174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR9958OtherMEDICAL LICENSE