Provider Demographics
NPI:1861505208
Name:MARTINEZ & LEWIS M.D.'S, P.A.
Entity Type:Organization
Organization Name:MARTINEZ & LEWIS M.D.'S, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:LUCIANO
Authorized Official - Middle Name:AUGUSTINE
Authorized Official - Last Name:MARTINEZ
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:813-870-3342
Mailing Address - Street 1:4129 N ARMENIA AVE
Mailing Address - Street 2:SUITE A
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33607
Mailing Address - Country:US
Mailing Address - Phone:813-870-3342
Mailing Address - Fax:813-877-7689
Practice Address - Street 1:4129 N ARMENIA AVE
Practice Address - Street 2:SUITE A
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33607-6436
Practice Address - Country:US
Practice Address - Phone:813-870-3342
Practice Address - Fax:813-877-7689
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-17
Last Update Date:2009-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0032863207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL271574100Medicaid
FL064971600Medicaid
FL042377700Medicaid
D62173Medicare UPIN
FL064971600Medicaid
FLK3322Medicare PIN
FL271574100Medicaid