Healthcare Provider Details

I. General information

NPI: 1285898205
Provider Name (Legal Business Name): MARTELL ENTERPRISES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/18/2008
Last Update Date: 07/18/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

AVE. FIDALGO DIAZ 4SS6 VILLA FONTANA
CAROLINA PR
00982
US

IV. Provider business mailing address

PO BOX 94
CAROLINA PR
00986
US

V. Phone/Fax

Practice location:
  • Phone: 787-776-3511
  • Fax:
Mailing address:
  • Phone: 787-776-3511
  • Fax: 787-776-2475

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332S00000X
TaxonomyHearing Aid Equipment
License Number
License Number State

VIII. Authorized Official

Name: MR. WILSON MARTELL
Title or Position: PRESIDENT
Credential:
Phone: 787-776-3511