Provider Demographics
NPI:1700969276
Name:MARTINEZ RAMOS, JOSE L (OD)
Entity Type:Individual
Prefix:
First Name:JOSE
Middle Name:L
Last Name:MARTINEZ RAMOS
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:JOSE
Other - Middle Name:
Other - Last Name:RAMOS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:OD
Mailing Address - Street 1:SAN PATRICIO PLAZA S/C
Mailing Address - Street 2:LOCAL F10 SAN PATRICIO PLAZA S/C
Mailing Address - City:GUAYNABO
Mailing Address - State:PR
Mailing Address - Zip Code:00968
Mailing Address - Country:US
Mailing Address - Phone:787-879-2202
Mailing Address - Fax:
Practice Address - Street 1:PLAZA ATLANTICO LOCAL #9
Practice Address - Street 2:
Practice Address - City:ARECIBO
Practice Address - State:PR
Practice Address - Zip Code:00612
Practice Address - Country:US
Practice Address - Phone:787-879-2202
Practice Address - Fax:787-879-5685
Is Sole Proprietor?:No
Enumeration Date:2006-10-20
Last Update Date:2018-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR275152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR196011Medicare UPIN