Provider Demographics
NPI:1265989198
Name:GOMEZ MARTINEZ, HECTOR MANUEL (PHD)
Entity type:Individual
Prefix:DR
First Name:HECTOR
Middle Name:MANUEL
Last Name:GOMEZ MARTINEZ
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4685 AVE CONSTANCIA
Mailing Address - Street 2:VILLA DEL CARMEN
Mailing Address - City:PONCE
Mailing Address - State:PR
Mailing Address - Zip Code:00716-2262
Mailing Address - Country:US
Mailing Address - Phone:787-984-9053
Mailing Address - Fax:
Practice Address - Street 1:4685 AVE CONSTANCIA
Practice Address - Street 2:VILLA DEL CARMEN
Practice Address - City:PONCE
Practice Address - State:PR
Practice Address - Zip Code:00716-2262
Practice Address - Country:US
Practice Address - Phone:787-984-9053
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-08
Last Update Date:2017-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR5673103TC0700X, 103TC2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent