Provider Demographics
NPI:1043088446
Name:MARTINEZ RODRIGUEZ, ANGEL LUIS (MSN-ED CERN)
Entity type:Individual
Prefix:PROF
First Name:ANGEL
Middle Name:LUIS
Last Name:MARTINEZ RODRIGUEZ
Suffix:
Gender:M
Credentials:MSN-ED CERN
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 370566
Mailing Address - Street 2:
Mailing Address - City:CAYEY
Mailing Address - State:PR
Mailing Address - Zip Code:00737-0566
Mailing Address - Country:US
Mailing Address - Phone:939-282-0085
Mailing Address - Fax:
Practice Address - Street 1:URBANIZACION TURABO GARDEN CARRETERA 172 SALIDA 21
Practice Address - Street 2:ESCUELA DE MEDICINA SAN JUAN BAUTISTA
Practice Address - City:CAGUAS
Practice Address - State:PR
Practice Address - Zip Code:00725-0072
Practice Address - Country:US
Practice Address - Phone:787-337-4208
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-12-14
Last Update Date:2023-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR03882163WN0800X, 163WC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC0200XNursing Service ProvidersRegistered NurseCritical Care Medicine
No163WN0800XNursing Service ProvidersRegistered NurseNeuroscience