Provider Demographics
NPI:1184613754
Name:MARTINEZ, DAVID E (MD)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:E
Last Name:MARTINEZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:138 AVE WINSTON CHURCHILL
Mailing Address - Street 2:MSC 753
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00926-6013
Mailing Address - Country:US
Mailing Address - Phone:787-768-8944
Mailing Address - Fax:787-768-8944
Practice Address - Street 1:4ES5 VIA LETICIA
Practice Address - Street 2:
Practice Address - City:CAROLINA
Practice Address - State:PR
Practice Address - Zip Code:00983-4807
Practice Address - Country:US
Practice Address - Phone:787-768-8944
Practice Address - Fax:787-768-8944
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-17
Last Update Date:2013-08-15
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PR6079207R00000X, 207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR0097544Medicare PIN