Provider Demographics
NPI:1184605495
Name:RODRIGUEZ-MARTIN, ARTURO (MD PL)
Entity type:Individual
Prefix:
First Name:ARTURO
Middle Name:
Last Name:RODRIGUEZ-MARTIN
Suffix:
Gender:M
Credentials:MD PL
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 496016
Mailing Address - Street 2:
Mailing Address - City:PORT CHARLOTTE
Mailing Address - State:FL
Mailing Address - Zip Code:33949-6016
Mailing Address - Country:US
Mailing Address - Phone:941-613-1356
Mailing Address - Fax:941-613-1591
Practice Address - Street 1:22099 ELMIRA BLVD
Practice Address - Street 2:
Practice Address - City:PORT CHARLOTTE
Practice Address - State:FL
Practice Address - Zip Code:33952-7018
Practice Address - Country:US
Practice Address - Phone:941-613-1351
Practice Address - Fax:941-613-1591
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-14
Last Update Date:2015-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME79916207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLH15455Medicare UPIN
FL35441AMedicare PIN