Provider Demographics
NPI:1003926528
Name:MARTINEZ, EDUARDO A (DC)
Entity Type:Individual
Prefix:DR
First Name:EDUARDO
Middle Name:A
Last Name:MARTINEZ
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3151 SW 27TH AVE
Mailing Address - Street 2:
Mailing Address - City:COCONUT GROVE
Mailing Address - State:FL
Mailing Address - Zip Code:33133-4634
Mailing Address - Country:US
Mailing Address - Phone:305-443-4636
Mailing Address - Fax:305-442-4641
Practice Address - Street 1:3151 SW 27TH AVE
Practice Address - Street 2:
Practice Address - City:COCONUT GROVE
Practice Address - State:FL
Practice Address - Zip Code:33133-4634
Practice Address - Country:US
Practice Address - Phone:305-443-4636
Practice Address - Fax:305-442-4641
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-30
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH7418111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL55778OtherBLUE CROSS/BLUE SHIELD ID
FLE0359YMedicare ID - Type UnspecifiedINDIVIDUAL DR. ID NUMBER
FL55778OtherBLUE CROSS/BLUE SHIELD ID