Provider Demographics
NPI:1770736449
Name:PADILLA-MARTINEZ, MELVIN (MD)
Entity type:Individual
Prefix:DR
First Name:MELVIN
Middle Name:
Last Name:PADILLA-MARTINEZ
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 1:201 CALLEJON OLIVERAS
Mailing Address - Street 2:
Mailing Address - City:CABO ROJO
Mailing Address - State:PR
Mailing Address - Zip Code:00623-3150
Mailing Address - Country:US
Mailing Address - Phone:787-412-5577
Mailing Address - Fax:787-264-5544
Practice Address - Street 1:HC 3 26504, RD 2 KM 173.4
Practice Address - Street 2:TORRE MEDICA SAN VICENTE DE PAUL SUITE 103
Practice Address - City:SAN GERMAN
Practice Address - State:PR
Practice Address - Zip Code:00683-9300
Practice Address - Country:US
Practice Address - Phone:787-892-9944
Practice Address - Fax:787-264-5544
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-28
Last Update Date:2020-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR17357208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice