Provider Demographics
NPI:1205144052
Name:MARTINEZ, XIOMARA D (APT)
Entity type:Individual
Prefix:
First Name:XIOMARA
Middle Name:D
Last Name:MARTINEZ
Suffix:
Gender:F
Credentials:APT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 644
Mailing Address - Street 2:
Mailing Address - City:LARES
Mailing Address - State:PR
Mailing Address - Zip Code:00669-0644
Mailing Address - Country:US
Mailing Address - Phone:787-453-5924
Mailing Address - Fax:
Practice Address - Street 1:CARR. 129 K. 24.8
Practice Address - Street 2:
Practice Address - City:LARES
Practice Address - State:PR
Practice Address - Zip Code:00669
Practice Address - Country:US
Practice Address - Phone:787-897-7877
Practice Address - Fax:787-897-8777
Is Sole Proprietor?:No
Enumeration Date:2010-09-15
Last Update Date:2010-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR2009225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant