Provider Demographics
NPI:1962475384
Name:MARTINEZ, MORAYMA (MD)
Entity Type:Individual
Prefix:
First Name:MORAYMA
Middle Name:
Last Name:MARTINEZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:38135 MARKET SQ
Mailing Address - Street 2:
Mailing Address - City:ZEPHYRHILLS
Mailing Address - State:FL
Mailing Address - Zip Code:33542-7505
Mailing Address - Country:US
Mailing Address - Phone:352-567-0188
Mailing Address - Fax:813-355-5101
Practice Address - Street 1:36763 EILAND BLVD
Practice Address - Street 2:SUITE 102
Practice Address - City:ZEPHYRHILLS
Practice Address - State:FL
Practice Address - Zip Code:33542
Practice Address - Country:US
Practice Address - Phone:813-778-0454
Practice Address - Fax:813-377-1699
Is Sole Proprietor?:No
Enumeration Date:2006-02-08
Last Update Date:2021-08-26
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME93886207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLP00884096OtherRR MEDICARE
FL277763100Medicaid
FLP00884096OtherRR MEDICARE