Provider Demographics
NPI:1013946458
Name:MARTINEZ, REBECA CARIDAD (MD)
Entity type:Individual
Prefix:
First Name:REBECA
Middle Name:CARIDAD
Last Name:MARTINEZ
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:REBECCA
Other - Middle Name:C
Other - Last Name:MARTINEZ
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 198054
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30384-8054
Mailing Address - Country:US
Mailing Address - Phone:786-662-7980
Mailing Address - Fax:
Practice Address - Street 1:800 SW 108TH AVE STE 100
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33174-2555
Practice Address - Country:US
Practice Address - Phone:305-348-3627
Practice Address - Fax:305-348-4261
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-30
Last Update Date:2025-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME54659207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL208792OtherAVMED
FL02077OtherBCBS
FL201600506OtherTAX ID
FL201600506OtherTAX ID
FL208792OtherAVMED