Provider Demographics
NPI:1922211754
Name:MARTINEZ-NEGRON, AXEL (DMD)
Entity Type:Individual
Prefix:DR
First Name:AXEL
Middle Name:
Last Name:MARTINEZ-NEGRON
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1380 SE PALM BEACH RD
Mailing Address - Street 2:
Mailing Address - City:PORT SAINT LUCIE
Mailing Address - State:FL
Mailing Address - Zip Code:34952-5318
Mailing Address - Country:US
Mailing Address - Phone:954-895-3309
Mailing Address - Fax:
Practice Address - Street 1:2654 N ANDREWS AVE STE 4
Practice Address - Street 2:
Practice Address - City:WILTON MANORS
Practice Address - State:FL
Practice Address - Zip Code:33311-2566
Practice Address - Country:US
Practice Address - Phone:954-567-3311
Practice Address - Fax:954-567-3361
Is Sole Proprietor?:No
Enumeration Date:2007-05-08
Last Update Date:2023-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN145091223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice