Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207P00000X | Emergency Physician | 13316 | PR |
N | 207PP0204X | Pediatric Emergency Physician | 13316 | PR |
NPI | 1730125410 |
---|---|
Provider Name | Maribel Rodriguez-Martinez |
First Address | San Juan, PR 00936-6210 |
Second Address | San Juan, PR 00918-1607 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/06/2006 |
Last Update Date | 04/12/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
F48280 | (02) | PR |