Provider Demographics
NPI:1053151837
Name:MARTINEZ, JANETTE MARIE
Entity type:Individual
Prefix:
First Name:JANETTE
Middle Name:MARIE
Last Name:MARTINEZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2D29 CALLE GENERAL ARANDA
Mailing Address - Street 2:
Mailing Address - City:TOA BAJA
Mailing Address - State:PR
Mailing Address - Zip Code:00949-5308
Mailing Address - Country:US
Mailing Address - Phone:787-688-6877
Mailing Address - Fax:
Practice Address - Street 1:2D29 CALLE GENERAL ARANDA
Practice Address - Street 2:
Practice Address - City:TOA BAJA
Practice Address - State:PR
Practice Address - Zip Code:00949-5308
Practice Address - Country:US
Practice Address - Phone:787-688-6877
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-29
Last Update Date:2024-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR1216156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician