Provider Demographics
NPI:1063840510
Name:EDUARDO M MARTINEZ, MD, PA
Entity Type:Organization
Organization Name:EDUARDO M MARTINEZ, MD, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:EDUARDO
Authorized Official - Middle Name:MILTON
Authorized Official - Last Name:MARTINEZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:305-510-3007
Mailing Address - Street 1:3659 S MIAMI AVE
Mailing Address - Street 2:SUITE 4006
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33133-4227
Mailing Address - Country:US
Mailing Address - Phone:786-483-8438
Mailing Address - Fax:305-532-7826
Practice Address - Street 1:3659 S MIAMI AVE
Practice Address - Street 2:SUITE 4006
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33133-4227
Practice Address - Country:US
Practice Address - Phone:786-483-8438
Practice Address - Fax:305-532-7826
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-10-18
Last Update Date:2013-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME00682152086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular SurgeryGroup - Single Specialty