Healthcare Provider Details

I. General information

NPI: 1073099131
Provider Name (Legal Business Name): ANA ISABEL MARTES BERMUDEZ MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/12/2018
Last Update Date: 04/10/2025
Certification Date: 04/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

C17 CALLE MARGINAL
BAYAMON PR
00961-6706
US

IV. Provider business mailing address

469 AVE ESMERALDA APT 168
GUAYNABO PR
00969-4284
US

V. Phone/Fax

Practice location:
  • Phone: 787-780-1273
  • Fax:
Mailing address:
  • Phone: 787-349-5642
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RA0401X
TaxonomyAddiction Medicine (Internal Medicine) Physician
License Number23974
License Number StatePR
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number23974
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: