Provider Demographics
NPI:1013229707
Name:DURAN-MARTINEZ, CARLOS ELIU (MD)
Entity Type:Individual
Prefix:DR
First Name:CARLOS
Middle Name:ELIU
Last Name:DURAN-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 1:407 SE 9TH ST
Mailing Address - Street 2:SUITE 103
Mailing Address - City:FORT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33316-1113
Mailing Address - Country:US
Mailing Address - Phone:954-463-0112
Mailing Address - Fax:954-463-0117
Practice Address - Street 1:407 SE 9TH ST
Practice Address - Street 2:SUITE 103
Practice Address - City:FORT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33316-1113
Practice Address - Country:US
Practice Address - Phone:954-463-0112
Practice Address - Fax:954-463-0117
Is Sole Proprietor?:No
Enumeration Date:2010-07-09
Last Update Date:2015-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME119578207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL011906800Medicaid
FL011906800Medicaid