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General NPI Number Information
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NPI Number | 1699844647
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Entity Type | Individual
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Provider Name | JUAN MARTINEZ R PH
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Gender | Male
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Dates
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Enumeration Date | 11/06/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | FARMACIA LUIS P R #4 INC 1501 PONCE DE LEON AVE
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City | SAN JUAN
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State | PR
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Zip | 00909-1779
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Country | US
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Telephone | 787-722-1590
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Fax | 787-724-3722
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Provider Business Mailing Address
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Address Line | URB. BELISA 1513 CAVALIERI ST.
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City | SAN JUAN
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State | PR
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Zip | 00927-6122
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Country | US
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Telephone | 787-758-9653
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Fax | 787-724-3722
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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 | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 2334
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License Number State | PR
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