Provider Demographics
NPI:1093448821
Name:MARTINEZ GIL, DORIS DE LA CARIDAD (DDS)
Entity Type:Individual
Prefix:DR
First Name:DORIS
Middle Name:DE LA CARIDAD
Last Name:MARTINEZ GIL
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:DR
Other - First Name:DORIS
Other - Middle Name:DE LA CARIDAD
Other - Last Name:MARTINEZ GIL
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DDS
Mailing Address - Street 1:930 N KROME AVE
Mailing Address - Street 2:
Mailing Address - City:HOMESTEAD
Mailing Address - State:FL
Mailing Address - Zip Code:33030-4418
Mailing Address - Country:US
Mailing Address - Phone:305-247-5161
Mailing Address - Fax:305-503-7253
Practice Address - Street 1:930 N KROME AVE
Practice Address - Street 2:
Practice Address - City:HOMESTEAD
Practice Address - State:FL
Practice Address - Zip Code:33030-4418
Practice Address - Country:US
Practice Address - Phone:305-247-5161
Practice Address - Fax:305-503-7253
Is Sole Proprietor?:Yes
Enumeration Date:2022-07-08
Last Update Date:2022-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN27291122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty