Provider Demographics
NPI:1801188909
Name:MARTINEZ, MARTA ELENA
Entity Type:Individual
Prefix:
First Name:MARTA
Middle Name:ELENA
Last Name:MARTINEZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:209 CALLE METIS
Mailing Address - Street 2:PASEO DEL SOL
Mailing Address - City:DORADO
Mailing Address - State:PR
Mailing Address - Zip Code:00646-4618
Mailing Address - Country:US
Mailing Address - Phone:787-278-8461
Mailing Address - Fax:787-278-8494
Practice Address - Street 1:C3 CALLE MARGINAL
Practice Address - Street 2:SARDINERA BEACH BUILDING SUITE 3
Practice Address - City:DORADO
Practice Address - State:PR
Practice Address - Zip Code:00646-2057
Practice Address - Country:US
Practice Address - Phone:787-278-3636
Practice Address - Fax:787-278-8494
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-07
Last Update Date:2011-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR541235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist