Provider Demographics
NPI:1063889202
Name:MM RHEUMATOLOGY LLC
Entity type:Organization
Organization Name:MM RHEUMATOLOGY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MELISA
Authorized Official - Middle Name:
Authorized Official - Last Name:MARTINEZ MARTI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-768-8944
Mailing Address - Street 1:PO BOX 79594
Mailing Address - Street 2:
Mailing Address - City:CAROLINA
Mailing Address - State:PR
Mailing Address - Zip Code:00984-9594
Mailing Address - Country:US
Mailing Address - Phone:787-768-8944
Mailing Address - Fax:
Practice Address - Street 1:4ES5 FRAGOSO AVE.
Practice Address - Street 2:
Practice Address - City:CAROLINA
Practice Address - State:PR
Practice Address - Zip Code:00983-0000
Practice Address - Country:US
Practice Address - Phone:787-768-8944
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-08-24
Last Update Date:2015-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR17,950207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatologyGroup - Single Specialty