Provider Demographics
NPI:1003128828
Name:MARTINEZ, RICARDO (MD)
Entity Type:Individual
Prefix:
First Name:RICARDO
Middle Name:
Last Name:MARTINEZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:851 5TH AVE N STE 102
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34102-5582
Mailing Address - Country:US
Mailing Address - Phone:239-315-7801
Mailing Address - Fax:855-888-3291
Practice Address - Street 1:851 5TH AVE N STE 102
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34102-5582
Practice Address - Country:US
Practice Address - Phone:239-315-7801
Practice Address - Fax:855-888-3291
Is Sole Proprietor?:No
Enumeration Date:2010-07-09
Last Update Date:2023-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME115110207R00000X, 208M00000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLL1428OtherMEDICARE
FL104729800Medicaid
FL207RA0401XMedicaid
FLHJ726VOtherMEDICARE