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General NPI Number Information
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NPI Number | 1649211905
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Entity Type | Individual
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Provider Name | MARISOL MARTINEZ MEDINA M.D.
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Gender | Female
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Dates
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Enumeration Date | 06/09/2006
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Last Update Date | 12/04/2008
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Provider Practice Location Address
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Address Line | MUNOZ RIVERA # 108
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City | CABO ROJO
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State | PR
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Zip | 00623
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Country | US
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Telephone | 787-851-2025
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Fax | 787-254-0235
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Provider Business Mailing Address
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Address Line | HC 8 BOX 297
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City | PONCE
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State | PR
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Zip | 00731-9720
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Country | US
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Telephone | 787-643-5862
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Fax | 787-841-1821
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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 | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | 15025
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License Number State | PR
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