Provider Demographics
NPI:1225132772
Name:MARTINEZ, JORGE C (MD)
Entity Type:Individual
Prefix:DR
First Name:JORGE
Middle Name:C
Last Name: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:PO BOX 801237
Mailing Address - Street 2:
Mailing Address - City:COTO LAUREL
Mailing Address - State:PR
Mailing Address - Zip Code:00780-1237
Mailing Address - Country:US
Mailing Address - Phone:787-848-6747
Mailing Address - Fax:
Practice Address - Street 1:42 CALLE BALDORIOTY
Practice Address - Street 2:
Practice Address - City:COAMO
Practice Address - State:PR
Practice Address - Zip Code:00769-3119
Practice Address - Country:US
Practice Address - Phone:787-825-8808
Practice Address - Fax:787-825-8808
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-12
Last Update Date:2022-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR10832174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR060241OtherLA CRUZ AZUL DE PUERTO RI
PR4310832OtherPLAN DE SALUD UIA
PR7690006OtherHUMANA
PR212606OtherPREFERRED HEALTH
PR3633OtherPREFERRED MEDICARE CHOICE
PR531OtherAMERICAN HEALTH MEDICARE
PR88696OtherTRIPLE S
PR200070OtherMEDICARE Y MUCHO MAS
PRM000355OtherPLAN DE SALUD MENONITA
PRM000355OtherPLAN DE SALUD MENONITA
PR88696OtherTRIPLE S