Healthcare Provider Details

I. General information

NPI: 1215157508
Provider Name (Legal Business Name): LUIS ORLANDO MARTINEZ-RIJOS RPHTCH
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/27/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

CARR 3 KM. 28.8
RIO GRANDE PR
00745
US

IV. Provider business mailing address

ER8 CALLE ACCESO
LUQUILLO PR
00773-2637
US

V. Phone/Fax

Practice location:
  • Phone: 787-887-2602
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183700000X
TaxonomyPharmacy Technician
License Number3263
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: