Ivelisse Martinez Montalvo
Individual provider Active NPI Audiologist · San Juan, PR
NPI 1639733603 · NPPES record last updated Apr 25, 2019
Key facts
- NPI
- 1639733603
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Audiologist 231H00000X
- License
- 001487 (PR)
- Practice address
- Carr 845 KM 2.2
D36 Ave Fairview
San Juan, PR 00919-0091 - Phone
- (787) 761-0036
- Fax
- (787) 292-5050
- NPI assigned
- Apr 25, 2019
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 001487 | PR | MD | Audiologist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Audiologist | 231H00000X | 001487 | PR | Yes |
Addresses
Primary practice location
Carr 845 KM 2.2
D36 Ave Fairview
San Juan, PR 00919-0091
Mailing address
PO Box 193069
San Juan, PR 00919-3069
Phone (787) 761-0036
Other providers in San Juan, PR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 25, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.