Provider Demographics
NPI:1487191805
Name:MARTINEZ, AURELIO JR (RPH)
Entity Type:Individual
Prefix:
First Name:AURELIO
Middle Name:
Last Name:MARTINEZ
Suffix:JR
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2801 NE 183RD ST APT 1616
Mailing Address - Street 2:
Mailing Address - City:AVENTURA
Mailing Address - State:FL
Mailing Address - Zip Code:33160-2132
Mailing Address - Country:US
Mailing Address - Phone:305-807-2929
Mailing Address - Fax:
Practice Address - Street 1:2801 NE 183RD ST
Practice Address - Street 2:APT 1616
Practice Address - City:AVENTURA
Practice Address - State:FL
Practice Address - Zip Code:33160-2100
Practice Address - Country:US
Practice Address - Phone:305-807-2929
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-01-23
Last Update Date:2017-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS23198183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist