Provider Demographics
NPI:1518602697
Name:MARTES, JOSUE (MD STUDENT)
Entity Type:Individual
Prefix:
First Name:JOSUE
Middle Name:
Last Name:MARTES
Suffix:
Gender:M
Credentials:MD STUDENT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 9020032
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00902-0032
Mailing Address - Country:US
Mailing Address - Phone:787-721-2160
Mailing Address - Fax:
Practice Address - Street 1:1451 AVE ASHFORD
Practice Address - Street 2:
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00907-1511
Practice Address - Country:US
Practice Address - Phone:787-235-6805
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-05-03
Last Update Date:2022-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program