Individual provider Active NPI

Juan Gabriel Martinez Rodriguez, MD

  • Student in an Organized Health Care Education/Training Program
  • San Juan, PR
National Provider Identifier
1205628997
Registry record updated May 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
715 Ave Ponce de Leon
San Juan, PR 00917-5032
Phone
(787) 758-2000
NPI assigned
May 20, 2025
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 20, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X PR Primary

Addresses

Primary practice location

715 Ave Ponce de Leon
San Juan, PR 00917-5032

Mailing address

Urb.Las Gaviotas F12 Calle Real
Toa Baja, PR 00949
Phone (939) 422-0814

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Medicine

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1747699200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747699200000",
    "number": "1205628997",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "URB.LAS GAVIOTAS F12 CALLE REAL",
            "city": "TOA BAJA",
            "state": "PR",
            "postal_code": "00949",
            "telephone_number": "939-422-0814"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "715 AVE PONCE DE LEON",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009175032",
            "telephone_number": "787-758-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTINEZ RODRIGUEZ",
        "first_name": "JUAN",
        "middle_name": "GABRIEL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-05-20",
        "last_updated": "2025-05-20",
        "certification_date": "2025-05-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "PR",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Juan, PR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.