Provider Demographics
NPI:1811635774
Name:MARTINEZ RIVERA, CHRISTOPHER LEE
Entity type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:LEE
Last Name:MARTINEZ RIVERA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 SANTA CECILIA ST
Mailing Address - Street 2:OCEAN PARK URB
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00911
Mailing Address - Country:US
Mailing Address - Phone:939-224-9278
Mailing Address - Fax:
Practice Address - Street 1:5 SANTA CECILIA ST
Practice Address - Street 2:OCEAN PARK URB
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00911
Practice Address - Country:US
Practice Address - Phone:939-224-9278
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-05-21
Last Update Date:2024-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program