Provider Demographics
NPI:1881650653
Name:MARTINEZ-MENDEZ, EUGENIA JOSEFINA (MD)
Entity Type:Individual
Prefix:MS
First Name:EUGENIA
Middle Name:JOSEFINA
Last Name:MARTINEZ-MENDEZ
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:W5 24 CERVANTES
Mailing Address - Street 2:URB HUCARES
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00926
Mailing Address - Country:US
Mailing Address - Phone:787-762-4646
Mailing Address - Fax:787-762-4269
Practice Address - Street 1:8TH STREET
Practice Address - Street 2:BLOCK 4 #7 SABANA GARDENS
Practice Address - City:CAROLINA
Practice Address - State:PR
Practice Address - Zip Code:00983
Practice Address - Country:US
Practice Address - Phone:787-762-4646
Practice Address - Fax:787-762-4269
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-21
Last Update Date:2011-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR4694208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
PRC79441Medicaid
PRC79441Medicare ID - Type Unspecified
PRC79441Medicaid