Provider Demographics
NPI:1750578001
Name:MARTINEZ MONTALVO, ELGA ESTHER (PHYSICAL THERAPIST)
Entity type:Individual
Prefix:MRS
First Name:ELGA
Middle Name:ESTHER
Last Name:MARTINEZ MONTALVO
Suffix:
Gender:F
Credentials:PHYSICAL THERAPIST
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Other - First Name:
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Mailing Address - Street 1:410 AVENIDA HOSTOS
Mailing Address - Street 2:SUITE 1
Mailing Address - City:MAYAGUEZ
Mailing Address - State:PR
Mailing Address - Zip Code:00682
Mailing Address - Country:US
Mailing Address - Phone:787-832-3100
Mailing Address - Fax:787-832-6015
Practice Address - Street 1:410 AVENIDA HOSTOS
Practice Address - Street 2:SUITE 1 CENTRO PEDIATRICO
Practice Address - City:MAYAGUEZ
Practice Address - State:PR
Practice Address - Zip Code:00682
Practice Address - Country:US
Practice Address - Phone:787-832-3100
Practice Address - Fax:787-832-6015
Is Sole Proprietor?:No
Enumeration Date:2007-10-01
Last Update Date:2007-10-01
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PR000772225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist