Provider Demographics
NPI:1851556211
Name:EMANUEL MARTINEZ MD AND ASSOCIATES
Entity Type:Organization
Organization Name:EMANUEL MARTINEZ MD AND ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:EMANUEL
Authorized Official - Middle Name:
Authorized Official - Last Name:MARTINEZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:904-278-4999
Mailing Address - Street 1:PO BOX 457
Mailing Address - Street 2:
Mailing Address - City:ORANGE PARK
Mailing Address - State:FL
Mailing Address - Zip Code:32067-0457
Mailing Address - Country:US
Mailing Address - Phone:904-278-4999
Mailing Address - Fax:904-278-8891
Practice Address - Street 1:1555 KINGSLEY AVE
Practice Address - Street 2:SUITE 101
Practice Address - City:ORANGE PARK
Practice Address - State:FL
Practice Address - Zip Code:32073-4560
Practice Address - Country:US
Practice Address - Phone:904-278-4999
Practice Address - Fax:904-278-8891
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-25
Last Update Date:2008-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME687582084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL1871598870OtherFRANK MORELLI LMHC NPI
FL78953ZOtherMEDICARE
FLK8704OtherMEDICARE
FLZ106MOtherBCBS
FL27411DOtherMEDICARE
FL101369137OtherMARK DEARING LCSW NPI
FL1033234653OtherSANDRA DARBY-CURRIE LMHC NPI
FL1033234653OtherSANDRA DARBY-CURRIE LMHC NPI