Provider Demographics
NPI:1386770063
Name:MARTINEZ, JOSELIN (MD)
Entity type:Individual
Prefix:
First Name:JOSELIN
Middle Name:
Last Name:MARTINEZ
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:MA47 PASEO DEL MONTE
Mailing Address - Street 2:URB. MONTE CLARO
Mailing Address - City:BAYAMON
Mailing Address - State:PR
Mailing Address - Zip Code:00961-4724
Mailing Address - Country:US
Mailing Address - Phone:787-421-3357
Mailing Address - Fax:
Practice Address - Street 1:MA47 PASEO DEL MONTE
Practice Address - Street 2:URB. MONTE CLARO
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00961-4724
Practice Address - Country:US
Practice Address - Phone:787-421-3357
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR16326208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice