Provider Demographics
NPI:1255504171
Name:MARTINEZ ORTIZ, BEATRIZ (LND MPHN)
Entity Type:Individual
Prefix:
First Name:BEATRIZ
Middle Name:
Last Name:MARTINEZ ORTIZ
Suffix:
Gender:F
Credentials:LND MPHN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:C/2 E1-2 4TH EXT URB METROPOLIS
Mailing Address - Street 2:
Mailing Address - City:CAROLINA
Mailing Address - State:PR
Mailing Address - Zip Code:00987
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:CAROLINA COMMERCIAL PARK 2420
Practice Address - Street 2:SUITE 1
Practice Address - City:CAROLINA
Practice Address - State:PR
Practice Address - Zip Code:00987-7169
Practice Address - Country:US
Practice Address - Phone:787-762-7840
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-04-11
Last Update Date:2008-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1305133N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133N00000XDietary & Nutritional Service ProvidersNutritionist