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General NPI Number Information
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NPI Number | 1275741753
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Entity Type | Organization
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Legal Business Name | CENTRO DE MEDICINA INTEGRAL AWILDA MARTINEZ
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Dates
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Enumeration Date | 05/18/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | CARRETERA 181 KM 8.4 BO. LA GLORIA
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City | TRUJILLO ALTO
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State | PR
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Zip | 00976
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Country | US
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Telephone | 787-748-3072
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 1918
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City | TRUJILLO ALTO
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State | PR
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Zip | 00977-1918
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Country | US
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Telephone | 787-748-3072
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. AWILDA C. MARTINEZ RODRIGUEZ
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Credential | MD
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Telephone | 787-748-3072
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 9463
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License Number State | PR
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