Individual
INDIRA ALEXANDRA MARTINEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
5675 N FRONT ST STE 141, PHILADELPHIA, PA 19120-2719
(267) 428-6575
Mailing address
204 AVE LAS PALMAS VILLAS MANATI, MANATI, PR 00674
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
32964
PR
207Q00000X
Family Medicine Physician
Primary
MD470643
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
413073181
—
NY
Enumeration date
06/29/2017
Last updated
11/04/2020
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