Provider Demographics
NPI:1497827273
Name:MARTINEZ, MARIA (PHARMACIST)
Entity Type:Individual
Prefix:MS
First Name:MARIA
Middle Name:
Last Name:MARTINEZ
Suffix:
Gender:F
Credentials:PHARMACIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:CARR. 486 ESQ. 455 BARRIO QUEBRADA
Mailing Address - Street 2:HC 02 BOX 7875
Mailing Address - City:CAMUY
Mailing Address - State:PR
Mailing Address - Zip Code:00627-9120
Mailing Address - Country:US
Mailing Address - Phone:787-385-8157
Mailing Address - Fax:787-898-7999
Practice Address - Street 1:CARR. 486 ESQ. 455 BARRIO QUEBRADA
Practice Address - Street 2:HC 02 BOX 7875
Practice Address - City:CAMUY
Practice Address - State:PR
Practice Address - Zip Code:00627-9120
Practice Address - Country:US
Practice Address - Phone:787-385-8157
Practice Address - Fax:787-898-7999
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-15
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR4137183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PRFARNEREIDAMedicare UPIN