Provider Demographics
NPI:1417270679
Name:MARTINEZ, ROSA JULIA (PSYD)
Entity Type:Individual
Prefix:DR
First Name:ROSA
Middle Name:JULIA
Last Name:MARTINEZ
Suffix:
Gender:F
Credentials:PSYD
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 273
Mailing Address - Street 2:
Mailing Address - City:AGUIRRE
Mailing Address - State:PR
Mailing Address - Zip Code:00704-0273
Mailing Address - Country:US
Mailing Address - Phone:787-432-1112
Mailing Address - Fax:787-853-2607
Practice Address - Street 1:CARR. # 3 KM. 151.4
Practice Address - Street 2:BO. COQUI
Practice Address - City:AGUIRRE
Practice Address - State:PR
Practice Address - Zip Code:00704
Practice Address - Country:US
Practice Address - Phone:787-853-2607
Practice Address - Fax:787-853-2607
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-02
Last Update Date:2010-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR2339103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical