MEDICARE: EDDANYS MARTINEZ M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	13077	PR

General Provider Information

NPI Number	:	1407831514
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	EDDANYS MARTINEZ M.D.

Provider Business Mailing Address
First Line	:	PO BOX 406
Second Line	:
City	:	SAN GERMAN
State	:	PR
Zip	:	00683-0406
Country	:	US
Telephone Number	:	787-892-4965
Fax Number	:	787-357-8736

Provider Business Practice Location Address
First Line	:	100 CALLE HERNAN ALVAREZ
Second Line	:	PLAZA METROPOLITANA SUITE 104
City	:	SAN GERMAN
State	:	PR
Zip	:	00683-4173
Country	:	US
Telephone Number	:	787-892-4965
Fax Number	:	787-357-8736

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/12/2005
Last Update Date	:	08/25/2023

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