Provider Demographics
NPI:1801242276
Name:CARAVEDO MARTINEZ, MARIA ALEJANDRA (MD)
Entity type:Individual
Prefix:
First Name:MARIA
Middle Name:ALEJANDRA
Last Name:CARAVEDO MARTINEZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:MARIA
Other - Middle Name:ALEJANDRA
Other - Last Name:CARAVEDO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 650859 DEPT 710
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75265-3806
Mailing Address - Country:US
Mailing Address - Phone:409-772-2222
Mailing Address - Fax:305-585-8137
Practice Address - Street 1:123 ANA DR
Practice Address - Street 2:
Practice Address - City:FLORENCE
Practice Address - State:AL
Practice Address - Zip Code:35630-1731
Practice Address - Country:US
Practice Address - Phone:256-349-2533
Practice Address - Fax:256-349-5946
Is Sole Proprietor?:No
Enumeration Date:2016-05-04
Last Update Date:2024-05-20
Deactivation Date:2016-12-30
Deactivation Code:
Reactivation Date:2017-04-28
Provider Licenses
StateLicense IDTaxonomies
TXT4719207RI0200X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program