Provider Demographics
NPI:1225276173
Name:MARTINEZ RIVERA, SANDRA IVETTE (MD)
Entity Type:Individual
Prefix:DR
First Name:SANDRA
Middle Name:IVETTE
Last Name:MARTINEZ RIVERA
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:HC 5 BOX 91824
Mailing Address - Street 2:
Mailing Address - City:ARECIBO
Mailing Address - State:PR
Mailing Address - Zip Code:00612-9520
Mailing Address - Country:US
Mailing Address - Phone:773-729-0911
Mailing Address - Fax:
Practice Address - Street 1:10 CASIA STREET
Practice Address - Street 2:VA CARIBBEAN HEALTH CARE SYSTEM
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00921
Practice Address - Country:US
Practice Address - Phone:787-641-7582
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-30
Last Update Date:2016-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036.1306392084P0800X, 261QM0850X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health