Provider Demographics
NPI:1164645065
Name:MARTINEZ GARCIA, ROSA J (PT)
Entity Type:Individual
Prefix:MS
First Name:ROSA
Middle Name:J
Last Name:MARTINEZ GARCIA
Suffix:
Gender:F
Credentials:PT
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 374
Mailing Address - Street 2:
Mailing Address - City:JUNCOS
Mailing Address - State:PR
Mailing Address - Zip Code:00777-0374
Mailing Address - Country:US
Mailing Address - Phone:787-502-1111
Mailing Address - Fax:787-893-3272
Practice Address - Street 1:26 CALLE CRISTOBAL COLON
Practice Address - Street 2:
Practice Address - City:YABUCOA
Practice Address - State:PR
Practice Address - Zip Code:00767-3326
Practice Address - Country:US
Practice Address - Phone:787-719-7799
Practice Address - Fax:787-893-3272
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-10
Last Update Date:2020-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR1128225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR0022444Medicare ID - Type UnspecifiedPROVIDER NUMBER