Provider Demographics
NPI:1972616852
Name:MARTORELL-MARQUEZ, GILBERTO J (MD)
Entity Type:Individual
Prefix:DR
First Name:GILBERTO
Middle Name:J
Last Name:MARTORELL-MARQUEZ
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 1:11 GABLE COURT
Mailing Address - Street 2:
Mailing Address - City:BRUNSWICK
Mailing Address - State:GA
Mailing Address - Zip Code:31525-6738
Mailing Address - Country:US
Mailing Address - Phone:912-466-5870
Mailing Address - Fax:912-466-5883
Practice Address - Street 1:11 GABLE COURT
Practice Address - Street 2:
Practice Address - City:BRUNSWICK
Practice Address - State:GA
Practice Address - Zip Code:31525-6738
Practice Address - Country:US
Practice Address - Phone:912-778-3556
Practice Address - Fax:912-778-3558
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-16
Last Update Date:2009-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA027088208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA00309647EMedicaid
GAD46033Medicare UPIN
GA37BDBNTMedicare ID - Type Unspecified