Provider Demographics
NPI:1548953037
Name:MARTINEZ TERRERO, YANINA I (PA)
Entity type:Individual
Prefix:
First Name:YANINA
Middle Name:I
Last Name:MARTINEZ TERRERO
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
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Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:HC 5 BOX 103353
Mailing Address - Street 2:
Mailing Address - City:MOCA
Mailing Address - State:PR
Mailing Address - Zip Code:00676-9721
Mailing Address - Country:US
Mailing Address - Phone:939-258-2379
Mailing Address - Fax:
Practice Address - Street 1:CALLE JOSE MENDEZ CARDONA #3
Practice Address - Street 2:
Practice Address - City:SAN SEBASTIAN
Practice Address - State:PR
Practice Address - Zip Code:00685
Practice Address - Country:US
Practice Address - Phone:787-896-1850
Practice Address - Fax:787-280-9497
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-31
Last Update Date:2023-06-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PR1647363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedicalGroup - Single Specialty