Provider Demographics
NPI:1891957940
Name:MARTINEZ, EDUARDO MIGUEL (MD)
Entity Type:Individual
Prefix:
First Name:EDUARDO
Middle Name:MIGUEL
Last Name:MARTINEZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7300 SW 93RD AVE STE 200
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33173-3212
Mailing Address - Country:US
Mailing Address - Phone:305-971-0510
Mailing Address - Fax:305-663-5929
Practice Address - Street 1:7300 SW 93RD AVE STE 200
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33173-3212
Practice Address - Country:US
Practice Address - Phone:305-903-0510
Practice Address - Fax:305-663-5929
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-30
Last Update Date:2022-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301093015207V00000X
FLME112645207VF0040X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VF0040XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyFemale Pelvic Medicine and Reconstructive Surgery
No207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL109660800Medicaid