Provider Demographics
NPI:1750415105
Name:MARTINEZ, GILBERTO (BSPH)
Entity type:Individual
Prefix:MR
First Name:GILBERTO
Middle Name:
Last Name:MARTINEZ
Suffix:
Gender:M
Credentials:BSPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:54 CALLE GEORGETTI
Mailing Address - Street 2:
Mailing Address - City:MANATI
Mailing Address - State:PR
Mailing Address - Zip Code:00674-5158
Mailing Address - Country:US
Mailing Address - Phone:787-688-2676
Mailing Address - Fax:787-858-2784
Practice Address - Street 1:9 CALLE CELIS AGUILERA
Practice Address - Street 2:
Practice Address - City:MANATI
Practice Address - State:PR
Practice Address - Zip Code:00674-5125
Practice Address - Country:US
Practice Address - Phone:787-688-2676
Practice Address - Fax:787-858-2784
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR2376183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist