Provider Demographics
NPI:1750419974
Name:MARTINEZ SANCHEZ, EVELISA (MD)
Entity type:Individual
Prefix:
First Name:EVELISA
Middle Name:
Last Name:MARTINEZ SANCHEZ
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 1:4000 AVE. SUITE 84
Mailing Address - Street 2:LAKEVIEW ESTATES
Mailing Address - City:CAGUAS
Mailing Address - State:PR
Mailing Address - Zip Code:00725
Mailing Address - Country:US
Mailing Address - Phone:787-704-1852
Mailing Address - Fax:
Practice Address - Street 1:4000 AVE. SUITE 84
Practice Address - Street 2:LAKEVIEW ESTATES
Practice Address - City:CAGUAS
Practice Address - State:PR
Practice Address - Zip Code:00725
Practice Address - Country:US
Practice Address - Phone:787-704-1852
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-01
Last Update Date:2020-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR138282085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology