Provider Demographics
NPI:1023096112
Name:MARTINEZ TORO, JOSE A SR (MD)
Entity type:Individual
Prefix:DR
First Name:JOSE
Middle Name:A
Last Name:MARTINEZ TORO
Suffix:SR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:576 CALLE TNTE CESAR GONZALEZ
Mailing Address - Street 2:DORAL BANK CENTER SUITE 305
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00918-3756
Mailing Address - Country:US
Mailing Address - Phone:787-751-2945
Mailing Address - Fax:787-281-6129
Practice Address - Street 1:576 CALLE TNTE CESAR GONZALEZ
Practice Address - Street 2:DORAL BANK CENTER SUITE 305
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00918-3756
Practice Address - Country:US
Practice Address - Phone:787-751-2945
Practice Address - Fax:787-281-6129
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR4736174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR0025712Medicare ID - Type Unspecified
PRD08339Medicare UPIN