Provider Demographics
NPI:1457374209
Name:MARTINEZ, VITERBO A (MD)
Entity type:Individual
Prefix:DR
First Name:VITERBO
Middle Name:A
Last Name:MARTINEZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7625 SW 62ND CT
Mailing Address - Street 2:
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34476-8322
Mailing Address - Country:US
Mailing Address - Phone:352-237-8903
Mailing Address - Fax:352-237-8962
Practice Address - Street 1:3301 SW 34TH CIR
Practice Address - Street 2:STE 301
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34474-6615
Practice Address - Country:US
Practice Address - Phone:352-236-7040
Practice Address - Fax:352-282-0108
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-25
Last Update Date:2019-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME75345207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL261767600Medicaid
FLG75493Medicare UPIN
FL261767600Medicaid