Provider Demographics
NPI:1356744916
Name:MARTINEZ, SONIA
Entity type:Individual
Prefix:
First Name:SONIA
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:LC 36 LA ANTIGUA
Mailing Address - Street 2:URB ENCANTADA
Mailing Address - City:TRUJILO ALTO
Mailing Address - State:PR
Mailing Address - Zip Code:00976
Mailing Address - Country:US
Mailing Address - Phone:787-283-8244
Mailing Address - Fax:
Practice Address - Street 1:LC 36 LA ANTIGUA
Practice Address - Street 2:URB ENCANTADA
Practice Address - City:TRUJILO ALTO
Practice Address - State:PR
Practice Address - Zip Code:00976
Practice Address - Country:US
Practice Address - Phone:787-283-8244
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-09-26
Last Update Date:2014-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR3509183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist