Provider Demographics
NPI:1134413701
Name:MARTINEZ-ORTIZ, YAIZA (MD)
Entity type:Individual
Prefix:
First Name:YAIZA
Middle Name:
Last Name:MARTINEZ-ORTIZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:29 CALLE WASHINGTON STE 601-602
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00907-1510
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:29 WASHINGTON STREET
Practice Address - Street 2:ASHFORD MEDICAL CENTER STE 601-602
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00907
Practice Address - Country:US
Practice Address - Phone:787-249-9560
Practice Address - Fax:509-275-5604
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-01
Last Update Date:2023-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR18688207RG0100X
PR18,688390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Single Specialty
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program