Provider Demographics
NPI:1154466738
Name:MARTINEZ, JULIE SUZETTE (DC)
Entity Type:Individual
Prefix:DR
First Name:JULIE
Middle Name:SUZETTE
Last Name:MARTINEZ
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:COND. PINE GROVE
Mailing Address - Street 2:APT 15A
Mailing Address - City:CAROLINA
Mailing Address - State:PR
Mailing Address - Zip Code:00979
Mailing Address - Country:US
Mailing Address - Phone:787-223-9160
Mailing Address - Fax:787-993-4529
Practice Address - Street 1:1665 AVE VICTOR LABIOSA
Practice Address - Street 2:SUITE 106
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00926-0001
Practice Address - Country:US
Practice Address - Phone:787-223-9160
Practice Address - Fax:787-993-4529
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-21
Last Update Date:2017-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR416111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor