Healthcare Provider Details

I. General information

NPI: 1598310674
Provider Name (Legal Business Name): FRANSHESKA MARTINEZ MEDINA OD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/06/2019
Last Update Date: 12/26/2019
Certification Date: 12/26/2019
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1900 AVE JESUS T PINERO
SAN JUAN PR
00921-1102
US

IV. Provider business mailing address

PO BOX 7891 PMB 333
GUAYNABO PR
00970
US

V. Phone/Fax

Practice location:
  • Phone: 939-630-4998
  • Fax:
Mailing address:
  • Phone: 787-782-2175
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number742-442
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: