Provider Demographics
NPI:1205276839
Name:MARTINEZ, NOEMI
Entity type:Individual
Prefix:
First Name:NOEMI
Middle Name:
Last Name:MARTINEZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:HC02 BOX 7604
Mailing Address - Street 2:CARRETERA155 KM 35.7
Mailing Address - City:OROCOVIS
Mailing Address - State:PR
Mailing Address - Zip Code:00720-9801
Mailing Address - Country:US
Mailing Address - Phone:787-315-9543
Mailing Address - Fax:
Practice Address - Street 1:HC02 BOX 7604
Practice Address - Street 2:CARRETERA155 KM 35.7
Practice Address - City:OROCOVIS
Practice Address - State:PR
Practice Address - Zip Code:00720-9801
Practice Address - Country:US
Practice Address - Phone:787-315-9543
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-27
Last Update Date:2014-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR1541235Z00000X
VA2202007317235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist