Provider Demographics
NPI:1619928389
Name:MARTINEZ, MARIA A (MD)
Entity Type:Individual
Prefix:DR
First Name:MARIA
Middle Name:A
Last Name:MARTINEZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:104 AVE EMERITO BETANCES
Mailing Address - Street 2:PO BOX 37-1696
Mailing Address - City:CAYEY
Mailing Address - State:PR
Mailing Address - Zip Code:00736-4730
Mailing Address - Country:US
Mailing Address - Phone:787-739-1810
Mailing Address - Fax:787-739-1810
Practice Address - Street 1:104 AVE EMERITO BETANCES
Practice Address - Street 2:
Practice Address - City:CAYEY
Practice Address - State:PR
Practice Address - Zip Code:00736-4730
Practice Address - Country:US
Practice Address - Phone:787-263-2105
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-15
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR9405174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR2-9405Medicare UPIN
PR062920Medicare UPIN
M00231Medicare UPIN
PR6240051Medicare UPIN
PR8-1803Medicare UPIN
PR04514Medicare UPIN
PR203300Medicare UPIN
PR3466Medicare UPIN