Provider Demographics
NPI:1578751772
Name:ALVARO I MARTINEZ JR MD PA
Entity Type:Organization
Organization Name:ALVARO I MARTINEZ JR MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ALVARO
Authorized Official - Middle Name:I
Authorized Official - Last Name:MARTINEZ
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:305-557-9300
Mailing Address - Street 1:7150 W 20TH AVE
Mailing Address - Street 2:STE 609
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33016-5529
Mailing Address - Country:US
Mailing Address - Phone:305-557-9300
Mailing Address - Fax:305-825-8424
Practice Address - Street 1:7150 W 20TH AVE
Practice Address - Street 2:STE 609
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33016-5529
Practice Address - Country:US
Practice Address - Phone:305-557-9300
Practice Address - Fax:305-825-8424
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-12
Last Update Date:2007-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME77074207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLK6122Medicare PIN
FLD54874Medicare UPIN