Provider Demographics
NPI:1164465472
Name:MARTINEZ, OSCAR (RPT)
Entity Type:Individual
Prefix:MR
First Name:OSCAR
Middle Name:
Last Name:MARTINEZ
Suffix:
Gender:M
Credentials:RPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2423 SW 147TH AVE
Mailing Address - Street 2:137
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33185-4082
Mailing Address - Country:US
Mailing Address - Phone:786-271-6767
Mailing Address - Fax:786-271-6767
Practice Address - Street 1:2423 SW 147TH AVE
Practice Address - Street 2:137
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33185-4082
Practice Address - Country:US
Practice Address - Phone:786-271-6767
Practice Address - Fax:786-271-6767
Is Sole Proprietor?:No
Enumeration Date:2006-06-14
Last Update Date:2008-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT 19308225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLY913BOtherBCBS FL
FL102579OtherAVMED
FL102579OtherAVMED