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NPI Code Detail

MEDICARE: MR. CARLOS VRIJIDO MARTINEZ

MEDICARE:  MR. CARLOS VRIJIDO MARTINEZ
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
11041C0700XClinical Social WorkerLW60580943WA
21041C0700XClinical Social WorkerLSCSW4773KS

General Provider Information

NPI Number : 1033388467
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. CARLOS VRIJIDO MARTINEZ
Provider Business Mailing Address
First Line : 3361 N ACADEMY BLVD
Second Line :
City : COLORADO SPRINGS
State : CO
Zip : 80917-5103
Country : US
Telephone Number : 719-285-7466
Fax Number : 719-409-0482
Provider Business Practice Location Address
First Line : 3361 N ACADEMY BLVD
Second Line :
City : COLORADO SPRINGS
State : CO
Zip : 80917-5103
Country : US
Telephone Number : 719-285-7466
Fax Number : 719-409-0482
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/29/2008
Last Update Date : 05/29/2024

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Directions to “ MR. CARLOS VRIJIDO MARTINEZ ” Practice Location

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