Healthcare Provider Details

I. General information

NPI: 1760474092
Provider Name (Legal Business Name): GUILLERMO EMILIO MARTINEZ RIOS MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/23/2005
Last Update Date: 05/18/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

EDIFICIO MEDICO HERMANAS DAVILA 16 CALLE B STE 105
BAYAMON PR
00959-5041
US

IV. Provider business mailing address

EDIFICIO MEDICO HERMANAS DAVILA 16 CALLE B STE 105
BAYAMON PR
00959-5041
US

V. Phone/Fax

Practice location:
  • Phone: 787-740-0120
  • Fax: 787-785-7787
Mailing address:
  • Phone: 787-740-0120
  • Fax: 787-785-7787

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License Number8265
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: