Provider Demographics
NPI:1134122625
Name:JANER-MARTINEZ, WALTER E (MD)
Entity Type:Individual
Prefix:DR
First Name:WALTER
Middle Name:E
Last Name:JANER-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:URB CROWN HILLS
Mailing Address - Street 2:152 CALLE GUAJATACA
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00926
Mailing Address - Country:US
Mailing Address - Phone:787-779-6666
Mailing Address - Fax:787-786-3501
Practice Address - Street 1:EDIF MEDICO SANTA CRUZ
Practice Address - Street 2:STE 215
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00961-6910
Practice Address - Country:US
Practice Address - Phone:787-779-6666
Practice Address - Fax:787-786-3501
Is Sole Proprietor?:Yes
Enumeration Date:2005-05-27
Last Update Date:2007-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR13568207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR0020995Medicare PIN
PRH68175Medicare UPIN
PR20995Medicare PIN