Provider Demographics
NPI:1417998097
Name:MARTINEZ, DIANA P (MD)
Entity Type:Individual
Prefix:DR
First Name:DIANA
Middle Name:P
Last Name:MARTINEZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:112 CALLE ARZUAGA
Mailing Address - Street 2:SUITE 802
Mailing Address - City:RIO PIEDRAS
Mailing Address - State:PR
Mailing Address - Zip Code:00925-3321
Mailing Address - Country:US
Mailing Address - Phone:787-767-6915
Mailing Address - Fax:787-765-4140
Practice Address - Street 1:112 CALLE ARZUAGA
Practice Address - Street 2:SUITE 802
Practice Address - City:RIO PIEDRAS
Practice Address - State:PR
Practice Address - Zip Code:00925-3321
Practice Address - Country:US
Practice Address - Phone:787-767-6915
Practice Address - Fax:787-765-4140
Is Sole Proprietor?:No
Enumeration Date:2006-06-08
Last Update Date:2017-02-23
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PR8224207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PRD34259Medicare UPIN