MEDICARE: MR. GABRIEL MARTINEZ-RODRIGUEZ MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RI0200X	Infectious Disease Physician	11939	PR

General Provider Information

NPI Number	:	1023063104
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. GABRIEL MARTINEZ-RODRIGUEZ MD

Provider Business Mailing Address
First Line	:	PO BOX 34239
Second Line	:
City	:	PONCE
State	:	PR
Zip	:	00734-0239
Country	:	US
Telephone Number	:	787-813-1836
Fax Number	:	787-813-1836

Provider Business Practice Location Address
First Line	:	SAN CRISTOBAL ANEXO TORRE I
Second Line	:
City	:	PONCE
State	:	PR
Zip	:	00780
Country	:	US
Telephone Number	:	787-848-2100
Fax Number	:	787-813-1836

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/24/2006
Last Update Date	:	04/29/2010

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