Provider Demographics
NPI:1780826487
Name:MARTINEZ, CLAUDIA N (DMD)
Entity Type:Individual
Prefix:
First Name:CLAUDIA
Middle Name:N
Last Name:MARTINEZ
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4213 S MANHATTAN AVE
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33611-1301
Mailing Address - Country:US
Mailing Address - Phone:813-605-2573
Mailing Address - Fax:813-605-2573
Practice Address - Street 1:4213 S MANHATTAN AVE
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33611-1301
Practice Address - Country:US
Practice Address - Phone:813-605-2573
Practice Address - Fax:813-605-2573
Is Sole Proprietor?:No
Enumeration Date:2009-03-27
Last Update Date:2015-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN18604122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL000975600Medicaid