Provider Demographics
NPI:1821469636
Name:MARTINEZ CASTRO, CARMEN HADASSAH (DC)
Entity Type:Individual
Prefix:
First Name:CARMEN
Middle Name:HADASSAH
Last Name:MARTINEZ CASTRO
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1602 CALLE SOL GOLDEN HILLS
Mailing Address - Street 2:
Mailing Address - City:DORADO
Mailing Address - State:PR
Mailing Address - Zip Code:00646
Mailing Address - Country:US
Mailing Address - Phone:939-439-8982
Mailing Address - Fax:
Practice Address - Street 1:503 CALLE EXTENSION S
Practice Address - Street 2:
Practice Address - City:DORADO
Practice Address - State:PR
Practice Address - Zip Code:00646-5016
Practice Address - Country:US
Practice Address - Phone:787-796-2900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-10-20
Last Update Date:2020-07-24
Deactivation Date:2020-02-25
Deactivation Code:
Reactivation Date:2020-06-17
Provider Licenses
StateLicense IDTaxonomies
PR0621111NN1001X
PR000621111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
No111NN1001XChiropractic ProvidersChiropractorNutrition