Provider Demographics
NPI:1265126098
Name:MARTINEZ, CARELI MICHELLE (MA, SLP)
Entity type:Individual
Prefix:MRS
First Name:CARELI
Middle Name:MICHELLE
Last Name:MARTINEZ
Suffix:
Gender:F
Credentials:MA, SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:AQ26 CALLE 50
Mailing Address - Street 2:
Mailing Address - City:BAYAMON
Mailing Address - State:PR
Mailing Address - Zip Code:00957-4219
Mailing Address - Country:US
Mailing Address - Phone:787-207-0084
Mailing Address - Fax:
Practice Address - Street 1:AQ26 CALLE 50
Practice Address - Street 2:
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00957-4219
Practice Address - Country:US
Practice Address - Phone:787-207-0084
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-05
Last Update Date:2023-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR004358235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist