Provider Demographics
NPI:1578973632
Name:MARTINEZ, ANA (PT)
Entity Type:Individual
Prefix:
First Name:ANA
Middle Name:
Last Name:MARTINEZ
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:P2 CALLE 17
Mailing Address - Street 2:URB VILLA MADRID
Mailing Address - City:COAMO
Mailing Address - State:PR
Mailing Address - Zip Code:00769-9516
Mailing Address - Country:US
Mailing Address - Phone:787-306-6669
Mailing Address - Fax:
Practice Address - Street 1:P2 CALLE 17
Practice Address - Street 2:URB VILLA MADRID
Practice Address - City:COAMO
Practice Address - State:PR
Practice Address - Zip Code:00769-9516
Practice Address - Country:US
Practice Address - Phone:787-306-6669
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-04-29
Last Update Date:2014-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR958225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist