Eugenia Josefina Martinez-Mendez, MD
Individual provider Active NPI General Practice Physician · Carolina, PR
NPI 1881650653 · NPPES record last updated Mar 16, 2011
Key facts
- NPI
- 1881650653
- Entity type
- Individual (NPI type 1)
- Primary specialty
- General Practice Physician 208D00000X
- License
- 4694 (PR)
- Practice address
- 8TH Street
Block 4 #7 Sabana Gardens
Carolina, PR 00983 - Phone
- (787) 762-4646
- Fax
- (787) 762-4269
- NPI assigned
- Apr 21, 2006
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in PR
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20081024000164 | PR | Practitioner - General Practice | 0143388827 | Practice locations: Carolina, PR |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4694 | PR | MD | Pharmacy Technician |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Physician | 208D00000X | 4694 | PR | Yes |
Addresses
Primary practice location
8TH Street
Block 4 #7 Sabana Gardens
Carolina, PR 00983
Mailing address
W5 24 Cervantes
Urb Hucares
San Juan, PR 00926
Phone (787) 762-4646
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| C79441 | Medicaid | PR |
Other providers in Carolina, PR
- Nahomi Martinez Laboy
- Norma Martinez Lopez
- Beatriz Martinez Ortiz
- Francisco J Martinez Rios
- Melisa Raquel Martinez-Marti
- Charlene M Martinez
- Daniel J. Martinez
- David E. Martinez
- Gines A Martinez
- Grace Marie Martinez
All providers in Carolina, PR · General Practice Physician in Puerto Rico
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 16, 2011. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.