MEDICARE: DR. LUIS ANGEL MARTINEZ-SUAREZ MD, MPH

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	208D00000X	General Practice Physician	11187	PR

General Provider Information

NPI Number	:	1235137977
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LUIS ANGEL MARTINEZ-SUAREZ MD, MPH

Provider Business Mailing Address
First Line	:	1379 PASEO DON JUAN
Second Line	:	APT. 8-B CONDADO
City	:	SAN JUAN
State	:	PR
Zip	:	00907-1428
Country	:	US
Telephone Number	:	787-722-7757
Fax Number	:	787-724-5104

Provider Business Practice Location Address
First Line	:	1306 AVE FERNANDEZ JUNCOS
Second Line	:
City	:	SAN JUAN
State	:	PR
Zip	:	00909-2521
Country	:	US
Telephone Number	:	787-722-5470
Fax Number	:	787-724-5104

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

Provider Enumeration Date	:	07/07/2005
Last Update Date	:	07/08/2007

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