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General NPI Number Information
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NPI Number | 1326838566
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Entity Type | Individual
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Provider Name | NATHANIEL MARTINEZ
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Gender | Male
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Dates
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Enumeration Date | 05/09/2025
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Last Update Date | 05/09/2025
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Provider Practice Location Address
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Address Line | 700 CARR 2 # 103
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City | VEGA ALTA
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State | PR
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Zip | 00692-6073
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Country | US
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Telephone | 787-224-7757
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Fax |
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Provider Business Mailing Address
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Address Line | AH11 CALLE 39
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City | BAYAMON
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State | PR
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Zip | 00956-4739
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Country | US
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Telephone | 787-233-5870
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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 | 103TC1900X
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Taxonomy Name | Counseling Psychologist
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License Number | 7823
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License Number State | PR
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