Provider Demographics
NPI:1609331420
Name:MACHIN MARTINEZ, ERAYSY
Entity Type:Individual
Prefix:
First Name:ERAYSY
Middle Name:
Last Name:MACHIN MARTINEZ
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:179-36 CALLE 439
Mailing Address - Street 2:
Mailing Address - City:CAROLINA
Mailing Address - State:PR
Mailing Address - Zip Code:00985-3517
Mailing Address - Country:US
Mailing Address - Phone:787-527-7008
Mailing Address - Fax:
Practice Address - Street 1:PASEO DR JOSE CELSO BARBOSA
Practice Address - Street 2:OFFICE A873
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00936-5067
Practice Address - Country:US
Practice Address - Phone:787-758-2525
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-02-06
Last Update Date:2019-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR801133680OtherUNIVERSITY OF PUERTO RICO MEDICAL SCIENCES CAMPUS