Provider Demographics
NPI:1356323927
Name:MARTINEZ-PICO, AMALIA (MD FACC)
Entity type:Individual
Prefix:
First Name:AMALIA
Middle Name:
Last Name:MARTINEZ-PICO
Suffix:
Gender:F
Credentials:MD FACC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 AVE DOMENECH
Mailing Address - Street 2:STE 303
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00918-3710
Mailing Address - Country:US
Mailing Address - Phone:787-767-2490
Mailing Address - Fax:
Practice Address - Street 1:400 AVE DOMENECH
Practice Address - Street 2:STE 303
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00918-3710
Practice Address - Country:US
Practice Address - Phone:787-767-2490
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-11-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PR18982080P0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0202XAllopathic & Osteopathic PhysiciansPediatricsPediatric Cardiology