Provider Demographics
NPI:1437350428
Name:DR. CARLOS M. MARTINEZ RIVERA CSP
Entity Type:Organization
Organization Name:DR. CARLOS M. MARTINEZ RIVERA CSP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWN
Authorized Official - Prefix:DR
Authorized Official - First Name:CARLOS
Authorized Official - Middle Name:M
Authorized Official - Last Name:MARTINEZ RIVERA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-805-0595
Mailing Address - Street 1:DOCTORS CENTER SUITE 204
Mailing Address - Street 2:CALLE NELSON PEREA 27
Mailing Address - City:MAYAGUEZ
Mailing Address - State:PR
Mailing Address - Zip Code:00680
Mailing Address - Country:US
Mailing Address - Phone:787-636-9154
Mailing Address - Fax:787-805-0620
Practice Address - Street 1:DOCTORS CENTER SUITE 204
Practice Address - Street 2:CALLE NELSON PEREA 27
Practice Address - City:MAYAGUEZ
Practice Address - State:PR
Practice Address - Zip Code:00680
Practice Address - Country:US
Practice Address - Phone:787-636-9154
Practice Address - Fax:787-805-0620
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-29
Last Update Date:2007-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & MetabolismGroup - Single Specialty