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General NPI Number Information
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NPI Number | 1235205048
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Entity Type | Individual
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Provider Name | CARMEN LAURA MARTINEZ MD
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Gender | Female
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Dates
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Enumeration Date | 11/27/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | CALLE BAHUINIA Z 977 LOIZA VALLEY
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City | CANOVANAS
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State | PR
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Zip | 00729
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Country | US
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Telephone | 787-886-1085
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Fax | 787-886-1085
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Provider Business Mailing Address
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Address Line | LF 121 VIA PARIS LA ANTIGUA ENCANTADA
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City | TRYILLO ALLO
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State | PR
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Zip | 00976
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Country | US
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Telephone | 787-283-8146
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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 | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 5624
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License Number State | PR
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