Healthcare Provider Details

I. General information

NPI: 1770538746
Provider Name (Legal Business Name): ISABEL TRIO-MARTINEZ M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/24/2006
Last Update Date: 05/28/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 AVE DOMENECH SUITE 605
SAN JUAN PR
00918-3710
US

IV. Provider business mailing address

7000 CARR 844 APT #45
SAN JUAN PR
00926-9570
US

V. Phone/Fax

Practice location:
  • Phone: 787-764-8000
  • Fax: 787-764-8509
Mailing address:
  • Phone: 787-748-8822
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QG0300X
TaxonomyGeriatric Medicine (Family Medicine) Physician
License Number13457
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: