MEDICARE: JORGE EDUARDO MARTINEZ-LLORENS M. D.

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	2085R0202X	Diagnostic Radiology Physician	12932	PR

General Provider Information

NPI Number	:	1558322313
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JORGE EDUARDO MARTINEZ-LLORENS M. D.

Provider Business Mailing Address
First Line	:	PO BOX 29460
Second Line	:
City	:	SAN JUAN
State	:	PR
Zip	:	00929-0460
Country	:	US
Telephone Number	:	787-758-2000
Fax Number	:	787-294-0527

Provider Business Practice Location Address
First Line	:	735 AVE. PONCE DE LEON
Second Line	:	DPTO. RADIOLOGIA 3R PISO
City	:	HATO REY
State	:	PR
Zip	:	00919-5022
Country	:	US
Telephone Number	:	787-758-2000
Fax Number	:	787-294-0527

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

Provider Enumeration Date	:	03/31/2006
Last Update Date	:	03/19/2018

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