Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VM0101X | Gynecologist - Maternal & Fetal Medicine | 13733 | PR |
NPI | 1073594404 |
---|---|
Provider Name | Edilberto Martinez |
First Address | Bayamon, PR 00961-6910 |
Second Address | Bayamon, PR 00961-6910 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 11/11/2005 |
Last Update Date | 11/10/2013 |