Provider Demographics
NPI:1376922500
Name:MARTINEZ, LIZBETH MARIE (RN BSN)
Entity Type:Individual
Prefix:MRS
First Name:LIZBETH
Middle Name:MARIE
Last Name:MARTINEZ
Suffix:
Gender:F
Credentials:RN BSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 485
Mailing Address - Street 2:
Mailing Address - City:SANTA ISABEL
Mailing Address - State:PR
Mailing Address - Zip Code:00757-0485
Mailing Address - Country:US
Mailing Address - Phone:787-630-7389
Mailing Address - Fax:
Practice Address - Street 1:372 CALLE 11
Practice Address - Street 2:BO SINGAPUR
Practice Address - City:JUANA DIAZ
Practice Address - State:PR
Practice Address - Zip Code:00795
Practice Address - Country:US
Practice Address - Phone:787-630-7389
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-05-20
Last Update Date:2015-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR72798163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse