Provider Demographics
NPI:1154704872
Name:MARTINEZ, ELGA MELISSA (MD)
Entity type:Individual
Prefix:
First Name:ELGA
Middle Name:MELISSA
Last Name:MARTINEZ
Suffix:
Gender:F
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:URBANIZACION PUNTO ORO CALLE LA DIANA 3512
Mailing Address - Street 2:
Mailing Address - City:PONCE
Mailing Address - State:PR
Mailing Address - Zip Code:00728-2012
Mailing Address - Country:US
Mailing Address - Phone:787-477-0646
Mailing Address - Fax:
Practice Address - Street 1:2864 CALLE HIBISCUS
Practice Address - Street 2:URB VILLA FLORES
Practice Address - City:PONCE
Practice Address - State:PR
Practice Address - Zip Code:00716-2914
Practice Address - Country:US
Practice Address - Phone:787-841-2878
Practice Address - Fax:787-841-2888
Is Sole Proprietor?:Yes
Enumeration Date:2015-06-30
Last Update Date:2023-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR21310207R00000X, 208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice