Individual
JONATHAN MICHAEL MARTINEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
618 MANZANO ST NE, ALBUQUERQUE, NM 87110-6302
(505) 925-4353
(505) 925-4354
Mailing address
618 MANZANO ST NE, ALBUQUERQUE, NM 87110-6302
(505) 925-4353
(505) 925-4354
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
NM
171M00000X
Case Manager/Care Coordinator
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
78670781
—
NM
Enumeration date
06/22/2017
Last updated
02/20/2020
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