Provider Demographics
NPI:1336219351
Name:MARTINEZ-ORRACA, JUAN JOSE (MD)
Entity Type:Individual
Prefix:DR
First Name:JUAN
Middle Name:JOSE
Last Name:MARTINEZ-ORRACA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:419 AVE. FELISA RINCON DE GAUTIER
Mailing Address - Street 2:URB. SAN DEMETRIO
Mailing Address - City:VEGA BAJA
Mailing Address - State:PR
Mailing Address - Zip Code:00693-3376
Mailing Address - Country:UM
Mailing Address - Phone:787-399-0036
Mailing Address - Fax:787-855-2767
Practice Address - Street 1:419 AVENIDA FELISA RINCON
Practice Address - Street 2:URBANIZACION SAN DEMETRIO
Practice Address - City:VEGA BAJA
Practice Address - State:PR
Practice Address - Zip Code:00693-3376
Practice Address - Country:US
Practice Address - Phone:787-855-2767
Practice Address - Fax:787-855-2767
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-08
Last Update Date:2016-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR9752207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR84528Medicare ID - Type Unspecified
PRG40403Medicare UPIN