Provider Demographics
NPI:1891464962
Name:MARTINEZ JIMENEZ, SAMUEL
Entity Type:Individual
Prefix:DR
First Name:SAMUEL
Middle Name:
Last Name:MARTINEZ JIMENEZ
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:COLLEGE PARK APARTMENTS
Mailing Address - Street 2:200 CALLE ALCALA APT 1702 B
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00921
Mailing Address - Country:US
Mailing Address - Phone:787-207-6524
Mailing Address - Fax:
Practice Address - Street 1:METRO HEALTHCARE MANANGEMENT SYSTEM
Practice Address - Street 2:BOLIVIA STREET #60
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00918
Practice Address - Country:US
Practice Address - Phone:787-230-7530
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-10
Last Update Date:2021-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174H00000XOther Service ProvidersHealth Educator