Provider Demographics
NPI:1902129463
Name:MARTINEZ, MEYLIN (RN)
Entity Type:Individual
Prefix:
First Name:MEYLIN
Middle Name:
Last Name:MARTINEZ
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:APARTAMENTO INTERAMERICANA GARDENS EDIFICIO A-15
Mailing Address - Street 2:APT 4A
Mailing Address - City:TRUJILLO ALTO
Mailing Address - State:PR
Mailing Address - Zip Code:00977
Mailing Address - Country:US
Mailing Address - Phone:787-810-5592
Mailing Address - Fax:
Practice Address - Street 1:CALLE 20 EDIFICIO A 15
Practice Address - Street 2:APARTAMENTO 4A
Practice Address - City:TRUJILLO ALTO
Practice Address - State:PR
Practice Address - Zip Code:00977
Practice Address - Country:US
Practice Address - Phone:787-810-5592
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-11
Last Update Date:2010-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR29288163W00000X, 163WW0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No163WW0000XNursing Service ProvidersRegistered NurseWound Care