Individual
DR. MICHAEL WALLACE MARTINEZ RODRIGUEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
COLINAS DEL PRADO, 57 CALLE REY CARLOS, JUANA DIAZ, PR 00795
(939) 325-7523
Mailing address
HC 3 BOX 11885, JUANA DIAZ, PR 00795-9579
(939) 325-7523
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
19848
PR
Other
Enumeration date
02/16/2018
Last updated
02/16/2018
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