Provider Demographics
NPI:1477837334
Name:MARTINEZ, LUZ E (DIRECTOR)
Entity Type:Individual
Prefix:MISS
First Name:LUZ
Middle Name:E
Last Name:MARTINEZ
Suffix:
Gender:F
Credentials:DIRECTOR
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Mailing Address - Street 1:21 CALLE SEVERO ARANA
Mailing Address - Street 2:STE 1
Mailing Address - City:SAN SEBASTIAN
Mailing Address - State:PR
Mailing Address - Zip Code:00685-2310
Mailing Address - Country:US
Mailing Address - Phone:787-896-3076
Mailing Address - Fax:787-896-3076
Practice Address - Street 1:21 CALLE SEVERO ARANA
Practice Address - Street 2:STE 1
Practice Address - City:SAN SEBASTIAN
Practice Address - State:PR
Practice Address - Zip Code:00685-2310
Practice Address - Country:US
Practice Address - Phone:787-896-3076
Practice Address - Fax:787-896-3076
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-10
Last Update Date:2013-10-11
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Provider Licenses
StateLicense IDTaxonomies
PR674291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR38149Medicare PIN