Provider Demographics
NPI:1417599663
Name:DR JOSE E MARTINEZ CAMPOS CSP
Entity Type:Organization
Organization Name:DR JOSE E MARTINEZ CAMPOS CSP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENTE
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSE
Authorized Official - Middle Name:E
Authorized Official - Last Name:MARTINEZ CAMPOS
Authorized Official - Suffix:
Authorized Official - Credentials:CSP
Authorized Official - Phone:787-260-4949
Mailing Address - Street 1:PO BOX 801085
Mailing Address - Street 2:
Mailing Address - City:COTO LAUREL
Mailing Address - State:PR
Mailing Address - Zip Code:00780-1085
Mailing Address - Country:US
Mailing Address - Phone:787-260-4949
Mailing Address - Fax:787-260-4949
Practice Address - Street 1:CALLE HOSTOS #5
Practice Address - Street 2:
Practice Address - City:JUANA DIAZ
Practice Address - State:PR
Practice Address - Zip Code:00795
Practice Address - Country:US
Practice Address - Phone:787-260-4949
Practice Address - Fax:787-260-4949
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-10-09
Last Update Date:2021-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty