Provider Demographics
NPI:1285790881
Name:MARTINEZ CHINEA, MIGUEL ANGEL (MD)
Entity type:Individual
Prefix:DR
First Name:MIGUEL
Middle Name:ANGEL
Last Name:MARTINEZ CHINEA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 275
Mailing Address - Street 2:
Mailing Address - City:VEGA ALTA
Mailing Address - State:PR
Mailing Address - Zip Code:00692-0275
Mailing Address - Country:US
Mailing Address - Phone:787-859-7182
Mailing Address - Fax:787-859-6846
Practice Address - Street 1:CALLE 1 CASA 1 URB. SANFELIZ
Practice Address - Street 2:ORTIZ MEDICAL PLAZA
Practice Address - City:COROZAL
Practice Address - State:PR
Practice Address - Zip Code:00783
Practice Address - Country:US
Practice Address - Phone:787-859-0112
Practice Address - Fax:787-859-6846
Is Sole Proprietor?:No
Enumeration Date:2006-12-28
Last Update Date:2016-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR8397208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
PRE78430Medicare UPIN