Provider Demographics
NPI:1962641720
Name:MARTINEZ, DORITZA (OTR/L)
Entity Type:Individual
Prefix:MS
First Name:DORITZA
Middle Name:
Last Name:MARTINEZ
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:BAIROA GOLDEN GATE 2
Mailing Address - Street 2:STREET I, N-13
Mailing Address - City:CAGUAS
Mailing Address - State:PR
Mailing Address - Zip Code:00727-1158
Mailing Address - Country:US
Mailing Address - Phone:787-475-4758
Mailing Address - Fax:
Practice Address - Street 1:BAIROA GOLDEN GATE 2
Practice Address - Street 2:STREET I, N-13
Practice Address - City:CAGUAS
Practice Address - State:PR
Practice Address - Zip Code:00727-1158
Practice Address - Country:US
Practice Address - Phone:787-475-4758
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-02-18
Last Update Date:2009-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR327225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics