Provider Demographics
NPI:1649994468
Name:MARTINEZ RIVERA, MELISSA MARGARITA (OD)
Entity type:Individual
Prefix:
First Name:MELISSA
Middle Name:MARGARITA
Last Name:MARTINEZ RIVERA
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:HC 3 BOX 31301
Mailing Address - Street 2:
Mailing Address - City:AGUADA
Mailing Address - State:PR
Mailing Address - Zip Code:00602-9754
Mailing Address - Country:US
Mailing Address - Phone:787-359-7745
Mailing Address - Fax:
Practice Address - Street 1:3241 AVE MILITAR
Practice Address - Street 2:
Practice Address - City:ISABELA
Practice Address - State:PR
Practice Address - Zip Code:00662-4091
Practice Address - Country:US
Practice Address - Phone:787-830-9000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-27
Last Update Date:2022-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR761152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist