Provider Demographics
NPI:1811994106
Name:MARTINEZ, HOWARD (MD)
Entity type:Individual
Prefix:DR
First Name:HOWARD
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:CREDENTIAL SERVICES
Mailing Address - Street 2:303 N CLYDE MORRIS BLVD.
Mailing Address - City:DAYTONA BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32114-2709
Mailing Address - Country:US
Mailing Address - Phone:386-425-2360
Mailing Address - Fax:386-226-4577
Practice Address - Street 1:INFECTIOUS DISEASE DEPARTMENT
Practice Address - Street 2:303 N CLYDE MORRIS BLVD.
Practice Address - City:DAYTONA BEACH
Practice Address - State:FL
Practice Address - Zip Code:32114-2709
Practice Address - Country:US
Practice Address - Phone:386-425-1997
Practice Address - Fax:386-425-7829
Is Sole Proprietor?:No
Enumeration Date:2005-07-01
Last Update Date:2020-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA80619207RI0200X, 207RI0200X
FLME64099207RI0200X, 207R00000X, 207RI0200X
RIMD08807207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
RI9020226Medicaid
RI9020226Medicaid
RI0449020226Medicare ID - Type Unspecified