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General NPI Number Information
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NPI Number | 1396183562
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Entity Type | Organization
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Legal Business Name | DIABETES AND METABOLISM INSTITUTE OF PUERTO RICO, PSC
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Dates
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Enumeration Date | 06/11/2013
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Last Update Date | 06/11/2013
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Provider Practice Location Address
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Address Line | 525 F.D. ROOSEVELT AVENUE LA TORRE DE PLAZA SUITE 711
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City | SAN JUAN
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State | PR
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Zip | 00918
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Country | US
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Telephone | 787-547-6355
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Fax |
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Provider Business Mailing Address
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Address Line | 10 2 SALAMANCA STEET TORRIMAR
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City | GUAYNABO
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State | PR
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Zip | 00966
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Country | US
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Telephone | 787-547-6355
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Fax |
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Authorized Official
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Title or Position | PRESIDENT & OWNER
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Name | DR. MELIZA MARTINEZ RODRIGUEZ
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Credential | M.D.
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Telephone | 787-547-6355
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RE0101X
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Taxonomy Name | Endocrinology, Diabetes & Metabolism Physician
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License Number | 16867
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License Number State | PR
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