Provider Demographics
NPI:1417096322
Name:MARTINEZ, KAREN
Entity Type:Individual
Prefix:MRS
First Name:KAREN
Middle Name:
Last Name:MARTINEZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:P. O. BOX 2008
Mailing Address - Street 2:
Mailing Address - City:AIBONITO
Mailing Address - State:PR
Mailing Address - Zip Code:00705-2008
Mailing Address - Country:US
Mailing Address - Phone:787-735-2456
Mailing Address - Fax:787-735-2456
Practice Address - Street 1:20 CALLE PEDRO ROSARIO
Practice Address - Street 2:SUITE 5E EDIFICIO AIBONITO PLAZA
Practice Address - City:AIBONITO
Practice Address - State:PR
Practice Address - Zip Code:00705-3243
Practice Address - Country:US
Practice Address - Phone:787-735-2456
Practice Address - Fax:787-735-2456
Is Sole Proprietor?:No
Enumeration Date:2007-02-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR3255183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician