Provider Demographics
NPI:1932868338
Name:MARTINEZ GONZALEZ, AILEEN W (EMERGENCY PARAMEDIC)
Entity Type:Individual
Prefix:MRS
First Name:AILEEN
Middle Name:W
Last Name:MARTINEZ GONZALEZ
Suffix:
Gender:F
Credentials:EMERGENCY PARAMEDIC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:CANDIDO PAGAN 428 BO COCO NEVO
Mailing Address - Street 2:
Mailing Address - City:SALINAS
Mailing Address - State:PR
Mailing Address - Zip Code:00751
Mailing Address - Country:US
Mailing Address - Phone:787-204-4233
Mailing Address - Fax:
Practice Address - Street 1:CANDIDO PAGAN 428 BO COCO NEVO
Practice Address - Street 2:
Practice Address - City:SALINAS
Practice Address - State:PR
Practice Address - Zip Code:00751
Practice Address - Country:US
Practice Address - Phone:787-204-4233
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-12-13
Last Update Date:2021-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR4546198343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)