Provider Demographics
NPI:1194118281
Name:ROSA ELIA MARTINEZ
Entity type:Organization
Organization Name:ROSA ELIA MARTINEZ
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ALT. ADMINISTRATOR/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ROSA
Authorized Official - Middle Name:ELIA
Authorized Official - Last Name:MARTINEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:956-546-1115
Mailing Address - Street 1:4035 BOCA CHICA BLVD STE 3
Mailing Address - Street 2:
Mailing Address - City:BROWNSVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78521-6160
Mailing Address - Country:US
Mailing Address - Phone:956-546-1115
Mailing Address - Fax:956-546-1104
Practice Address - Street 1:4035 BOCA CHICA BLVD STE 3
Practice Address - Street 2:
Practice Address - City:BROWNSVILLE
Practice Address - State:TX
Practice Address - Zip Code:78521
Practice Address - Country:US
Practice Address - Phone:956-546-1115
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-12
Last Update Date:2019-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
253Z00000X
TX0168713747P1801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care AttendantGroup - Multi-Specialty
No253Z00000XAgenciesIn Home Supportive CareGroup - Multi-Specialty