Provider Demographics
NPI:1356317911
Name:MARTINEZ-RODRIGUEZ, JUAN CARLOS (MD)
Entity Type:Individual
Prefix:DR
First Name:JUAN
Middle Name:CARLOS
Last Name:MARTINEZ-RODRIGUEZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:BAYAMON MEDICAL MALL # 1845
Mailing Address - Street 2:CARR #2 SUITE 209
Mailing Address - City:BAYAMON
Mailing Address - State:PR
Mailing Address - Zip Code:00959-7200
Mailing Address - Country:US
Mailing Address - Phone:787-620-2098
Mailing Address - Fax:787-779-8178
Practice Address - Street 1:BAYAMON MEDICAL MALL # 1845
Practice Address - Street 2:CARR #2 ST 209
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00959-7200
Practice Address - Country:US
Practice Address - Phone:787-620-2098
Practice Address - Fax:787-779-8178
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-24
Last Update Date:2016-07-15
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PR8967208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR31-08967OtherUIA
PR6230057OtherHUMANA INSURANCE
PR067100OtherLA CRUZ AZUL PUERTO RICO
PR204183OtherU T I
PR28967OtherCIGNA HEALTH CARE
PR601156OtherMEDICARE MUCHO MAS
PR6230057OtherHUMANA HEALTH PLAN
PRN-189OtherIMC
PR80449OtherTRIPLE S
PR6230057OtherHUMANA HEALTH PLAN
PR80449OtherTRIPLE S