Provider Demographics
NPI:1619393998
Name:MARTINS, JEFFREY DEAN (SA-C)
Entity Type:Individual
Prefix:MR
First Name:JEFFREY
Middle Name:DEAN
Last Name:MARTINS
Suffix:
Gender:M
Credentials:SA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6705 SW 57TH AVE STE 501
Mailing Address - Street 2:
Mailing Address - City:SOUTH MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33143-3644
Mailing Address - Country:US
Mailing Address - Phone:786-471-4299
Mailing Address - Fax:305-397-1154
Practice Address - Street 1:6705 SW 57TH AVE STE 501
Practice Address - Street 2:
Practice Address - City:SOUTH MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33143-3644
Practice Address - Country:US
Practice Address - Phone:786-471-4299
Practice Address - Fax:305-397-1154
Is Sole Proprietor?:No
Enumeration Date:2014-03-11
Last Update Date:2014-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL14-126246ZC0007X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZC0007XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Assistant