Provider Demographics
NPI:1407347909
Name:MARTINEZ-DIAZ, HILDABELIS (MD)
Entity Type:Individual
Prefix:
First Name:HILDABELIS
Middle Name:
Last Name:MARTINEZ-DIAZ
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 1:771 CALLE TEODORO AGUILAR
Mailing Address - Street 2:URB. LOS MAESTROS
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00923-2435
Mailing Address - Country:US
Mailing Address - Phone:352-219-1285
Mailing Address - Fax:
Practice Address - Street 1:771 CALLE TEODORO AGUILAR
Practice Address - Street 2:URB. LOS MAESTROS
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00923
Practice Address - Country:US
Practice Address - Phone:352-219-1285
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-05-21
Last Update Date:2018-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR012961207ZP0102X, 208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
No207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology