Provider Demographics
NPI:1396917555
Name:MARTINEZ ORTIZ, GLORIMAR (MD)
Entity type:Individual
Prefix:MRS
First Name:GLORIMAR
Middle Name:
Last Name:MARTINEZ ORTIZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 CALLE ALDRIN
Mailing Address - Street 2:SANTA CLARA
Mailing Address - City:JAYUYA
Mailing Address - State:PR
Mailing Address - Zip Code:00664-1501
Mailing Address - Country:US
Mailing Address - Phone:787-538-6520
Mailing Address - Fax:
Practice Address - Street 1:10 CALLE ALDRIN
Practice Address - Street 2:SANTA CLARA
Practice Address - City:JAYUYA
Practice Address - State:PR
Practice Address - Zip Code:00664-1501
Practice Address - Country:US
Practice Address - Phone:787-538-6520
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-27
Last Update Date:2008-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR17075208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice