Provider Demographics
NPI:1457376964
Name:MARTINEZ, RAMON (MD)
Entity Type:Individual
Prefix:
First Name:RAMON
Middle Name:
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 1:1417 N SEMORAN BLVD
Mailing Address - Street 2:SUITE 203
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32807-3555
Mailing Address - Country:US
Mailing Address - Phone:407-206-1106
Mailing Address - Fax:
Practice Address - Street 1:1417 N SEMORAN BLVD
Practice Address - Street 2:SUITE 203
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32807-3555
Practice Address - Country:US
Practice Address - Phone:407-206-1106
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME534102084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLE21563Medicare UPIN
FL07740YMedicare ID - Type Unspecified