Provider Demographics
NPI:1235137977
Name:MARTINEZ-SUAREZ, LUIS ANGEL (MD, MPH)
Entity type:Individual
Prefix:DR
First Name:LUIS
Middle Name:ANGEL
Last Name:MARTINEZ-SUAREZ
Suffix:
Gender:M
Credentials:MD, MPH
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Other - First Name:
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Mailing Address - Street 1:1379 PASEO DON JUAN
Mailing Address - Street 2:APT. 8-B CONDADO
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00907-1428
Mailing Address - Country:US
Mailing Address - Phone:787-722-7757
Mailing Address - Fax:787-724-5104
Practice Address - Street 1:1306 AVE FERNANDEZ JUNCOS
Practice Address - Street 2:
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00909-2521
Practice Address - Country:US
Practice Address - Phone:787-722-5470
Practice Address - Fax:787-724-5104
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR11187208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
PRF94734Medicare UPIN