Provider Demographics
NPI:1851171367
Name:MARTINEZ LANTIGUA, MISAEL (DC)
Entity Type:Individual
Prefix:
First Name:MISAEL
Middle Name:
Last Name:MARTINEZ LANTIGUA
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:131 CALLE 2
Mailing Address - Street 2:
Mailing Address - City:GUAYNABO
Mailing Address - State:PR
Mailing Address - Zip Code:00965-5803
Mailing Address - Country:US
Mailing Address - Phone:787-946-4664
Mailing Address - Fax:
Practice Address - Street 1:131 CALLE 2
Practice Address - Street 2:
Practice Address - City:GUAYNABO
Practice Address - State:PR
Practice Address - Zip Code:00965-5803
Practice Address - Country:US
Practice Address - Phone:787-946-4664
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-02
Last Update Date:2023-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR941111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor