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General NPI Number Information
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NPI Number | 1972597557
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Entity Type | Individual
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Provider Name | MARITZA MARTINEZ VARGAS
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Gender | Female
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Dates
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Enumeration Date | 09/09/2005
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Last Update Date | 11/04/2015
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Provider Practice Location Address
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Address Line | AVENIDA UNIVERSIDAD INTERAMERICANA CALLE 143
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City | SAN GERMAN
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State | PUERTO RICO
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Zip | 00683
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Country | UM
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Telephone | 787-892-6060
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Fax | 787-892-6060
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Provider Business Mailing Address
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Address Line | PO BOX 326
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City | SAN GERMAN
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State | PUERTO RICO
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Zip | 00683
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Country | UM
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Telephone | 787-892-6060
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Fax | 787-892-6060
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 7568
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License Number State | PR
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