Provider Demographics
NPI:1396845954
Name:MARTINEZ, EDUARDO MILTON (MD)
Entity Type:Individual
Prefix:
First Name:EDUARDO
Middle Name:MILTON
Last Name: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 1:3659 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
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-24
Last Update Date:2017-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME00682152086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL252061300Medicaid
FL252061300Medicaid
FL27187YMedicare PIN
KY64024698Medicaid
KYG11504 7474Medicare UPIN
FL27187YMedicare PIN