MEDICARE: MARTA ELENA 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
1	235Z00000X	Speech-Language Pathologist	541	PR

General Provider Information

NPI Number	:	1801188909
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARTA ELENA MARTINEZ

Provider Business Mailing Address
First Line	:	209 CALLE METIS
Second Line	:	PASEO DEL SOL
City	:	DORADO
State	:	PR
Zip	:	00646-4618
Country	:	US
Telephone Number	:	787-278-8461
Fax Number	:	787-278-8494

Provider Business Practice Location Address
First Line	:	C3 CALLE MARGINAL
Second Line	:	SARDINERA BEACH BUILDING SUITE 3
City	:	DORADO
State	:	PR
Zip	:	00646-2057
Country	:	US
Telephone Number	:	787-278-3636
Fax Number	:	787-278-8494

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

Provider Enumeration Date	:	05/07/2011
Last Update Date	:	05/07/2011

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Directions to “ MARTA ELENA MARTINEZ ” Practice Location

Language	Start Address	Practice Location

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