Provider Demographics
NPI:1356451736
Name:MARTINEZ OLIVIERI, ROSELYN (MD)
Entity Type:Individual
Prefix:DR
First Name:ROSELYN
Middle Name:
Last Name:MARTINEZ OLIVIERI
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:PMB 608
Mailing Address - Street 2:CALLE SIERRA MORENA #267
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00926-0000
Mailing Address - Country:US
Mailing Address - Phone:787-604-9123
Mailing Address - Fax:
Practice Address - Street 1:SANTA MARIA SHOPPING CENTER
Practice Address - Street 2:CARRETERA 177 LOCAL A-11(B)
Practice Address - City:GUAYNABO
Practice Address - State:PR
Practice Address - Zip Code:00970-0000
Practice Address - Country:US
Practice Address - Phone:787-604-9123
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-30
Last Update Date:2011-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR13354207RA0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RA0000XAllopathic & Osteopathic PhysiciansInternal MedicineAdolescent Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PRH67312Medicare UPIN