Provider Demographics
NPI:1689133001
Name:GONZALEZ MARTINEZ, DAMARIS (RN)
Entity Type:Individual
Prefix:
First Name:DAMARIS
Middle Name:
Last Name:GONZALEZ MARTINEZ
Suffix:
Gender:F
Credentials:RN
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 2500 PMB 778
Mailing Address - Street 2:
Mailing Address - City:TOA BAJA
Mailing Address - State:PR
Mailing Address - Zip Code:00951
Mailing Address - Country:US
Mailing Address - Phone:787-223-4084
Mailing Address - Fax:
Practice Address - Street 1:ALTURAS DE HACIENDA DORADA
Practice Address - Street 2:2 CALLE ESMERALDA
Practice Address - City:TOA BAJA
Practice Address - State:PR
Practice Address - Zip Code:00951
Practice Address - Country:US
Practice Address - Phone:787-223-4084
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-03-15
Last Update Date:2023-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR021947163W00000X
PR39381163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR021947OtherNURSES EXAMINER BOARD
PR39381OtherREGISTERED NURSE - NURSES EXAMINER BOARD