Provider Demographics
NPI:1962778837
Name:MARTINEZ, LINDA J (MS SLP)
Entity type:Individual
Prefix:MRS
First Name:LINDA
Middle Name:J
Last Name:MARTINEZ
Suffix:
Gender:F
Credentials:MS SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:GOLFO DE MEXICO ST. PASEO LOS CORALES I
Mailing Address - Street 2:# 570
Mailing Address - City:DORADO
Mailing Address - State:PR
Mailing Address - Zip Code:00646
Mailing Address - Country:US
Mailing Address - Phone:787-278-3637
Mailing Address - Fax:
Practice Address - Street 1:PASEO LOS CORALES I, ST. GOLFO DE MEXICO
Practice Address - Street 2:# 570
Practice Address - City:DORADO
Practice Address - State:PR
Practice Address - Zip Code:00646-4512
Practice Address - Country:US
Practice Address - Phone:787-278-3637
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-26
Last Update Date:2012-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR332235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist