Provider Demographics
NPI:1972649564
Name:MARTINEZ, ANA LUZ (MD)
Entity Type:Individual
Prefix:DR
First Name:ANA
Middle Name:LUZ
Last Name:MARTINEZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:ANNIE
Other - Middle Name:
Other - Last Name:MARTINEZ
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 3308
Mailing Address - Street 2:
Mailing Address - City:AGUADILLA
Mailing Address - State:PR
Mailing Address - Zip Code:00605-3308
Mailing Address - Country:US
Mailing Address - Phone:787-882-2440
Mailing Address - Fax:787-882-2440
Practice Address - Street 1:#172 107 AVE.
Practice Address - Street 2:
Practice Address - City:AGUADILLA
Practice Address - State:PR
Practice Address - Zip Code:00604
Practice Address - Country:US
Practice Address - Phone:787-882-2440
Practice Address - Fax:787-882-2440
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR63792080A0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080A0000XAllopathic & Osteopathic PhysiciansPediatricsAdolescent Medicine