Provider Demographics
NPI:1073500096
Name:MARTINEZ RUIZ, SILVIO R (MD)
Entity type:Individual
Prefix:
First Name:SILVIO
Middle Name:R
Last Name:MARTINEZ RUIZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:DR PAVIA ST # 700
Mailing Address - Street 2:205
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00909
Mailing Address - Country:US
Mailing Address - Phone:787-982-5328
Mailing Address - Fax:787-982-3822
Practice Address - Street 1:700 CALLE DR PAVIA FERNANDEZ
Practice Address - Street 2:SUITE 205
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00909-2758
Practice Address - Country:US
Practice Address - Phone:787-982-5328
Practice Address - Fax:787-982-3822
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-04
Last Update Date:2018-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR13682208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR0020404Medicare ID - Type Unspecified
PRH42442Medicare UPIN