Healthcare Provider Details

I. General information

NPI: 1376622597
Provider Name (Legal Business Name): EDITH I. MARTINEZ RPH.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/06/2006
Last Update Date: 07/18/2025
Certification Date: 07/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1750 CARR 2 STE 1
BARCELONETA PR
00617-3355
US

IV. Provider business mailing address

PO BOX 2020 PMB 159
BARCELONETA PR
00617-2020
US

V. Phone/Fax

Practice location:
  • Phone: 787-846-4583
  • Fax: 787-846-2890
Mailing address:
  • Phone: 787-485-6477
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number4420
License Number StatePR

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: