Provider Demographics
NPI:1205348216
Name:MARTINEZ RIVERA, JOEL ANTONIO (DC)
Entity type:Individual
Prefix:
First Name:JOEL
Middle Name:ANTONIO
Last Name:MARTINEZ RIVERA
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1210 E OSCEOLA PKWY STE 302
Mailing Address - Street 2:
Mailing Address - City:KISSIMMEE
Mailing Address - State:FL
Mailing Address - Zip Code:34744-1621
Mailing Address - Country:US
Mailing Address - Phone:386-801-4184
Mailing Address - Fax:407-807-0008
Practice Address - Street 1:1210 E OSCEOLA PKWY STE 302
Practice Address - Street 2:
Practice Address - City:KISSIMMEE
Practice Address - State:FL
Practice Address - Zip Code:34744-1621
Practice Address - Country:US
Practice Address - Phone:407-801-0101
Practice Address - Fax:407-807-0008
Is Sole Proprietor?:Yes
Enumeration Date:2017-10-31
Last Update Date:2024-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH12283111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor