Provider Demographics
NPI:1164575668
Name:MARTINEZ FERNANDEZ, NITZA (MD)
Entity Type:Individual
Prefix:MRS
First Name:NITZA
Middle Name:
Last Name:MARTINEZ FERNANDEZ
Suffix:
Gender:F
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:PO BOX 477
Mailing Address - Street 2:
Mailing Address - City:ARECIBO
Mailing Address - State:PR
Mailing Address - Zip Code:00613-0477
Mailing Address - Country:US
Mailing Address - Phone:787-881-3325
Mailing Address - Fax:
Practice Address - Street 1:AVENIDA PRINCIPAL 94
Practice Address - Street 2:BARRIO BAJADERO
Practice Address - City:ARECIBO
Practice Address - State:PR
Practice Address - Zip Code:00616-0799
Practice Address - Country:US
Practice Address - Phone:787-881-3325
Practice Address - Fax:787-881-3325
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-19
Last Update Date:2010-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR6617208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR6215OtherINTERNATIONAL MEDICAL CARD
PR3832OtherPREFERRED MEDICARE CHOICE
PR100270OtherMEDICARE Y MUCHO MAS
PR3938704OtherCIGNA HEALTHCARE
PR6239OtherAMERICAN HEALTH MEDICARE
PR83216MAOtherTRIPLE-S SALUD
PR83216Medicare PIN
PR3938704OtherCIGNA HEALTHCARE