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General NPI Number Information
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NPI Number | 1053151837
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Entity Type | Individual
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Provider Name | JANETTE MARIE MARTINEZ
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Gender | Female
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Dates
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Enumeration Date | 05/29/2024
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Last Update Date | 05/29/2024
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Provider Practice Location Address
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Address Line | 2D29 CALLE GENERAL ARANDA
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City | TOA BAJA
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State | PR
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Zip | 00949-5308
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Country | US
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Telephone | 787-688-6877
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Fax |
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Provider Business Mailing Address
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Address Line | 2D29 CALLE GENERAL ARANDA
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City | TOA BAJA
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State | PR
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Zip | 00949-5308
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Country | US
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Telephone | 787-688-6877
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 156FX1800X
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Taxonomy Name | Optician
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License Number | 1216
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License Number State | PR
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