Provider Demographics
NPI:1306251491
Name:DIAZ MARTINEZ, GERMARILIZ (MD)
Entity type:Individual
Prefix:MRS
First Name:GERMARILIZ
Middle Name:
Last Name:DIAZ 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:B24 BDA. NUEVA
Mailing Address - Street 2:
Mailing Address - City:UTUADO
Mailing Address - State:PR
Mailing Address - Zip Code:00641
Mailing Address - Country:US
Mailing Address - Phone:787-297-5732
Mailing Address - Fax:
Practice Address - Street 1:URB. MENDEZ #2
Practice Address - Street 2:ISTITUTO PEDIATRICO OFICINA 5
Practice Address - City:YABUCOA
Practice Address - State:PR
Practice Address - Zip Code:00767
Practice Address - Country:US
Practice Address - Phone:787-266-3128
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-06-26
Last Update Date:2014-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR18794208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR4539097OtherDRIVER LICENSE