Provider Demographics
NPI:1245569433
Name:FERNANDO L MARTINEZ HNC MARTINEZ AMBULANCE
Entity Type:Organization
Organization Name:FERNANDO L MARTINEZ HNC MARTINEZ AMBULANCE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:FERNANDO
Authorized Official - Middle Name:
Authorized Official - Last Name:MARTINEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-359-3613
Mailing Address - Street 1:HC 4 BOX 3024
Mailing Address - Street 2:
Mailing Address - City:BARRANQUITAS
Mailing Address - State:PR
Mailing Address - Zip Code:00794-9639
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:BO PALO HINCADO SEC LA TORRE CARR 770 KM 1.0 INTERIOR
Practice Address - Street 2:
Practice Address - City:BARRANQUITA
Practice Address - State:PR
Practice Address - Zip Code:00794
Practice Address - Country:US
Practice Address - Phone:787-359-3613
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-12-17
Last Update Date:2010-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR0058659Medicare UPIN