Provider Demographics
NPI:1801946850
Name:MARTINEZ-PAGAN, LIZA D (OD)
Entity type:Individual
Prefix:
First Name:LIZA
Middle Name:D
Last Name:MARTINEZ-PAGAN
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:PO BOX 140382
Mailing Address - Street 2:
Mailing Address - City:ARECIBO
Mailing Address - State:PR
Mailing Address - Zip Code:00614-0382
Mailing Address - Country:US
Mailing Address - Phone:787-760-3763
Mailing Address - Fax:
Practice Address - Street 1:725 AVENIDA W. MAINE
Practice Address - Street 2:STE 600-620
Practice Address - City:SIERRA BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00961-4470
Practice Address - Country:US
Practice Address - Phone:787-778-1777
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR572152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist