1538864558 NPI number — ALANIS NAHIRA GOMEZ-MARTINEZ

Table of content: ALANIS NAHIRA GOMEZ-MARTINEZ (NPI 1538864558)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1538864558 NPI number — ALANIS NAHIRA GOMEZ-MARTINEZ

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
GOMEZ-MARTINEZ
Provider First Name:
ALANIS
Provider Middle Name:
NAHIRA
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1538864558
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
04/07/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
15 ERLICH CT
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LAJAS
Provider Business Mailing Address State Name:
PR
Provider Business Mailing Address Postal Code:
00667-2624
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
787-372-8767
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
UNIVERSITY OF PUERTO RICO, MEDICAL SCIENCES CAMPUS
Provider Second Line Business Practice Location Address:
PASEO DR. JOSE CELSO BARBOSA
Provider Business Practice Location Address City Name:
SAN JUAN
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00921-0092
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-758-2525
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
03/31/2023

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 390200000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)