Provider Demographics
NPI:1962430801
Name:GARRATON - MARTIN, MIGUEL R (MD)
Entity type:Individual
Prefix:DR
First Name:MIGUEL
Middle Name:R
Last Name:GARRATON - MARTIN
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 1:138 WINSTON CHURCHILL AVE.
Mailing Address - Street 2:MSC 837
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00926-6023
Mailing Address - Country:US
Mailing Address - Phone:787-756-8126
Mailing Address - Fax:
Practice Address - Street 1:369 AVE. DE DIEGO
Practice Address - Street 2:TORRE MEDICA SAN FRANCISCO SUITE 506
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00923
Practice Address - Country:US
Practice Address - Phone:787-756-8126
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-29
Last Update Date:2013-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR8736207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PRD34204Medicare UPIN