Provider Demographics
NPI:1184684136
Name:MARTINEZ, ALVARO A (MD)
Entity type:Individual
Prefix:
First Name:ALVARO
Middle Name:A
Last Name:MARTINEZ
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 1:2234 COLONIAL BLVD
Mailing Address - Street 2:ATTN: PAYER CONTRACTING & RELATIONS
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33907-1412
Mailing Address - Country:US
Mailing Address - Phone:239-931-7342
Mailing Address - Fax:239-931-7385
Practice Address - Street 1:28595 ORCHARD LAKE RD
Practice Address - Street 2:
Practice Address - City:FARMINGTON HILLS
Practice Address - State:MI
Practice Address - Zip Code:48334-2977
Practice Address - Country:US
Practice Address - Phone:248-553-0606
Practice Address - Fax:248-553-7674
Is Sole Proprietor?:No
Enumeration Date:2006-03-24
Last Update Date:2012-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI43010491922085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1046265OtherHEALTH PLUS OF MI THRU OPNS
MIP01013936OtherRAILROAD MEDICARE
MI105330OtherUNITED HEALTHCARE COMMUNITY PLAN
MI41721OtherMERIDIAN HEALTH PLAN
MI5404207OtherAETNA THRU OAKLAND PHYSICIANS NETWORK SERVICES
MI320F362430OtherBCBSM
MI5404207OtherAETNA
MI1756902Medicaid
MI5404207OtherAETNA
MI5404207OtherAETNA THRU OAKLAND PHYSICIANS NETWORK SERVICES
MI0F36076002Medicare PIN