Healthcare Provider Details

I. General information

NPI: 1548696628
Provider Name (Legal Business Name): DR. ADRIANO MARTINEZ RIVERA - CARDIOLOGO, C.S.P.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/19/2013
Last Update Date: 09/19/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18 AVE SEVERIANO CUEVAS ANEXO HOSP BUEN SAMARITANO PISO 1
AGUADILLA PR
00603
US

IV. Provider business mailing address

PO BOX 430 SUITE 1036
MAYAGUEZ PR
00681-0430
US

V. Phone/Fax

Practice location:
  • Phone: 787-882-0175
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM2500X
TaxonomyMedical Specialty Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: GLADYS DEL VALLE
Title or Position: MANAGER
Credential:
Phone: 787-882-0175