Provider Demographics
NPI:1942947825
Name:MARTINEZ RUIZ, PEDRO P (APRN)
Entity Type:Individual
Prefix:
First Name:PEDRO
Middle Name:P
Last Name:MARTINEZ RUIZ
Suffix:
Gender:M
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5411 W 5TH AVE
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33012-2537
Mailing Address - Country:US
Mailing Address - Phone:786-870-9418
Mailing Address - Fax:
Practice Address - Street 1:8356 SW 40TH ST STE L
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33155-3356
Practice Address - Country:US
Practice Address - Phone:786-870-9418
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-12
Last Update Date:2022-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN9521286163WG0000X
FLAPRN11018377363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
No163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice