Provider Demographics
NPI:1477895837
Name:MARTINEZ, HUMBERTO (MA)
Entity Type:Individual
Prefix:PROF
First Name:HUMBERTO
Middle Name:
Last Name:MARTINEZ
Suffix:
Gender:M
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:900 W 49TH ST
Mailing Address - Street 2:SUITE 505
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33012-3402
Mailing Address - Country:US
Mailing Address - Phone:305-200-1270
Mailing Address - Fax:305-200-1271
Practice Address - Street 1:900 W 49TH ST
Practice Address - Street 2:SUITE 505
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33012-3402
Practice Address - Country:US
Practice Address - Phone:305-200-1270
Practice Address - Fax:305-200-1271
Is Sole Proprietor?:Yes
Enumeration Date:2013-03-25
Last Update Date:2013-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLHCC10486261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy