Provider Demographics
NPI:1578043055
Name:MARTINEZ, SYLVIA (PHD)
Entity Type:Individual
Prefix:DR
First Name:SYLVIA
Middle Name:
Last Name:MARTINEZ
Suffix:
Gender:F
Credentials:PHD
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 363166
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00936-3166
Mailing Address - Country:US
Mailing Address - Phone:787-405-3663
Mailing Address - Fax:787-293-4298
Practice Address - Street 1:URB LA CUMBRE
Practice Address - Street 2:265 CALLE SIERRA MORENA
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00926
Practice Address - Country:US
Practice Address - Phone:787-287-1731
Practice Address - Fax:787-287-1731
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-15
Last Update Date:2018-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR1568103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical