Provider Demographics
NPI:1346537073
Name:MARTINEZ, JOMAR G (TECH)
Entity Type:Individual
Prefix:MR
First Name:JOMAR
Middle Name:G
Last Name:MARTINEZ
Suffix:
Gender:M
Credentials:TECH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:URB.VILLA DELICIAS 4335 CALLE GIMNASIA
Mailing Address - Street 2:
Mailing Address - City:PONCE
Mailing Address - State:PUERTO RICO
Mailing Address - Zip Code:00728
Mailing Address - Country:UM
Mailing Address - Phone:787-284-5143
Mailing Address - Fax:
Practice Address - Street 1:URB.VILLA DELICIAS CALLE GIMNASIA
Practice Address - Street 2:4335
Practice Address - City:PONCE
Practice Address - State:PR
Practice Address - Zip Code:00728-3716
Practice Address - Country:US
Practice Address - Phone:787-284-5143
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-07-01
Last Update Date:2011-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR007550183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician