Provider Demographics
NPI:1023089836
Name:MARTINEZ SCMIDT, FERNANDO (MD)
Entity type:Individual
Prefix:DR
First Name:FERNANDO
Middle Name:
Last Name:MARTINEZ SCMIDT
Suffix:
Gender:M
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:PMB 535 89 DE DIEGO
Mailing Address - Street 2:SUITE 105
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00927-6346
Mailing Address - Country:US
Mailing Address - Phone:787-504-8080
Mailing Address - Fax:787-767-6743
Practice Address - Street 1:AVE PONCE DE LEON # 728
Practice Address - Street 2:
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00919
Practice Address - Country:US
Practice Address - Phone:787-754-9720
Practice Address - Fax:787-767-6743
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-30
Last Update Date:2009-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR119002084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR20453MAOtherSSS
PR0020453Medicare PIN
PR20453MAOtherSSS