Healthcare Provider Details

I. General information

NPI: 1871159533
Provider Name (Legal Business Name): KAREN NEREIDA MARTI MARTINEZ MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/17/2019
Last Update Date: 05/17/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

PR 2 KM 11.7 SECTOR PAJAROS
BAYAMON PR
00959
US

IV. Provider business mailing address

PMB 22 BOX 8901
HATILLO PR
00659
US

V. Phone/Fax

Practice location:
  • Phone: 787-474-8282
  • Fax: 787-474-5438
Mailing address:
  • Phone: 787-474-8282
  • Fax: 787-474-5438

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number13781
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: