Provider Demographics
NPI:1295757003
Name:MARTINEZ-WILLIAMS, ROBIN J (DC)
Entity type:Individual
Prefix:
First Name:ROBIN
Middle Name:J
Last Name:MARTINEZ-WILLIAMS
Suffix:
Gender:F
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:PO BOX 33384
Mailing Address - Street 2:
Mailing Address - City:INDIALANTIC
Mailing Address - State:FL
Mailing Address - Zip Code:32903-0384
Mailing Address - Country:US
Mailing Address - Phone:352-653-7962
Mailing Address - Fax:
Practice Address - Street 1:429 5TH AVE
Practice Address - Street 2:
Practice Address - City:INDIALANTIC
Practice Address - State:FL
Practice Address - Zip Code:32903-4240
Practice Address - Country:US
Practice Address - Phone:321-733-4434
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-24
Last Update Date:2018-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH12217111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
088802TY6Medicare ID - Type UnspecifiedPART B
V40166Medicare UPIN