Individual
MARTHA IVETT KYRIACOU
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1511 AVE PONCE DE LEON, SAN JUAN, PR 00909-5001
(787) 339-2639
Mailing address
1511 AVE PONCE DE LEON, SAN JUAN, PR 00909-5001
(787) 339-2639
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
21174
PR
390200000X
Student in an Organized Health Care Education/Training Program
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Other
Enumeration date
05/04/2017
Last updated
10/23/2020
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