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NPI 1275080806

NPI 1275080806 : MARIELA RAQUEL MARTINEZ-RIVERA MD, MS : PONCE, PR

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General NPI Number Information
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    NPI Number           |    1275080806
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    Entity Type          |    Individual 
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    Provider Name        |    MARIELA RAQUEL MARTINEZ-RIVERA MD, MS
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    09/01/2016
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    Last Update Date     |    10/15/2025
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Provider Practice Location Address
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    Address Line         |    909 AVE TITO CASTRO STE 710-711 
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    City                 |    PONCE
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    State                |    PR
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    Zip                  |    00716-4728
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    Country              |    US
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    Telephone            |    917-794-5710
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    909 AVE TITO CASTRO STE 710-711 
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    City                 |    PONCE
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    State                |    PR
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    Zip                  |    00716-4728
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    Country              |    US
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    Telephone            |    917-794-5710
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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        |    208800000X
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    Taxonomy Name        |    Urology Physician
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    License Number       |    024302
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    License Number State |    PR
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Taxonomy #2
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    Taxonomy Code        |    390200000X
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    Taxonomy Name        |    Student in an Organized Health Care Education/Training Program
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    License Number       |    
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    License Number State |    
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