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General NPI Number Information
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NPI Number | 1639474646
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Entity Type | Individual
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Provider Name | MELVIN MIGUEL MARTINEZ PSY. D.
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Gender | Male
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Dates
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Enumeration Date | 01/22/2011
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Last Update Date | 01/22/2011
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Provider Practice Location Address
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Address Line | 1130 CALLE VALLEJO
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City | RIO PIEDRAS
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State | PR
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Zip | 00925-3440
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Country | US
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Telephone | 787-274-8260
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Fax |
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Provider Business Mailing Address
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Address Line | URB. EXT. PARKVILLE CALLE NEVADA ZA-8
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City | GUAYNABO
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State | PUERTO RICO
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Zip | 00627
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Country | UM
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Telephone | 787-599-1025
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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 | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 3779
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License Number State | PR
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