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Individual

MR. ALFONSO BENJAMIN MARTINEZ JR.

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
FNP-BC

Contact information

Practice address
1518 GIRARD BLVD NE, ALBUQUERQUE, NM 87106-6908
(505) 266-3835
Mailing address
PO BOX 26666, PHS PROVIDER ENROLLMENT, ALBUQUERQUE, NM 87125-6666
(505) 923-6770
(505) 923-5354

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
CNP-03046
NM

Other

Enumeration date
09/12/2016
Last updated
07/09/2018
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