Provider Demographics
NPI:1952502361
Name:MARTINEZ, APOLINAR RUIZ
Entity Type:Individual
Prefix:DR
First Name:APOLINAR
Middle Name:RUIZ
Last Name:MARTINEZ
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:BOX 84
Mailing Address - Street 2:
Mailing Address - City:MANATI
Mailing Address - State:PR
Mailing Address - Zip Code:00674
Mailing Address - Country:US
Mailing Address - Phone:787-854-1005
Mailing Address - Fax:787-854-5543
Practice Address - Street 1:URBANIZACION VILLA MARIA
Practice Address - Street 2:B-1, MARGINAL
Practice Address - City:MANATI
Practice Address - State:PR
Practice Address - Zip Code:00674
Practice Address - Country:US
Practice Address - Phone:787-854-1005
Practice Address - Fax:787-854-5543
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR4552174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR4552OtherLINCENCIA MEDICA
PR4552OtherLINCENCIA MEDICA