Provider Demographics
NPI:1982366878
Name:PEREZ-MARTINEZ, MARCOS A (REGISTERED NURSE)
Entity Type:Individual
Prefix:
First Name:MARCOS
Middle Name:A
Last Name:PEREZ-MARTINEZ
Suffix:
Gender:M
Credentials:REGISTERED NURSE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:170 CARR 189
Mailing Address - Street 2:
Mailing Address - City:GURABO
Mailing Address - State:PR
Mailing Address - Zip Code:00778-3090
Mailing Address - Country:US
Mailing Address - Phone:787-649-4141
Mailing Address - Fax:
Practice Address - Street 1:170 CARR 189
Practice Address - Street 2:
Practice Address - City:GURABO
Practice Address - State:PR
Practice Address - Zip Code:00778-3090
Practice Address - Country:US
Practice Address - Phone:787-649-4141
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-10-08
Last Update Date:2021-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR38101163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse