Provider Demographics
NPI:1871688044
Name:MARTINEZ CHIROPRACTIC CENTER, INC.
Entity Type:Organization
Organization Name:MARTINEZ CHIROPRACTIC CENTER, INC.
Other - Org Name:MARTINEZ CHIROPRACTIC CENTER, INC.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:NELLY
Authorized Official - Middle Name:
Authorized Official - Last Name:ESPINEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-388-7577
Mailing Address - Street 1:12595 SW 137TH AVE
Mailing Address - Street 2:STE 107
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33186-4220
Mailing Address - Country:US
Mailing Address - Phone:305-388-7577
Mailing Address - Fax:305-388-7851
Practice Address - Street 1:12595 SW 137TH AVE
Practice Address - Street 2:STE 107
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33186-4220
Practice Address - Country:US
Practice Address - Phone:305-388-7577
Practice Address - Fax:305-388-7851
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-04
Last Update Date:2010-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL380061000Medicaid
FLU27675Medicare UPIN
22728Medicare ID - Type Unspecified