Provider Demographics
NPI:1962507038
Name:MARTINEZ-ALBA, JOSE RAMON JR (MD)
Entity Type:Individual
Prefix:DR
First Name:JOSE
Middle Name:RAMON
Last Name:MARTINEZ-ALBA
Suffix:JR
Gender:M
Credentials:MD
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Mailing Address - Street 1:7100 W 20TH AVE
Mailing Address - Street 2:PALMETTO MEDICAL PLAZA SUITE 514
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33016-1897
Mailing Address - Country:US
Mailing Address - Phone:305-556-2255
Mailing Address - Fax:305-821-7958
Practice Address - Street 1:7100 W 20TH AVE
Practice Address - Street 2:PALMETTO MEDICAL PLAZA SUITE 514
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33016-1824
Practice Address - Country:US
Practice Address - Phone:305-556-2255
Practice Address - Fax:305-821-7958
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-14
Last Update Date:2020-03-12
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Provider Licenses
StateLicense IDTaxonomies
FLME55751208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL039476900Medicaid
FLE65219Medicare UPIN
FL09098Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER