Healthcare Provider Details

I. General information

NPI: 1053975920
Provider Name (Legal Business Name): ABIGAIL MARTINEZ PT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/26/2019
Last Update Date: 04/26/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

180 CHALETS DE LA PLAYA
VEGA BAJA PR
00693-9756
US

IV. Provider business mailing address

180 CHALETS DE LA PLAYA
VEGA BAJA PR
00693
US

V. Phone/Fax

Practice location:
  • Phone: 787-782-8250
  • Fax:
Mailing address:
  • Phone: 787-782-8250
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number538
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: