Provider Demographics
NPI:1982972345
Name:MARTINEZ, SERGIO ANDRE (DO)
Entity Type:Individual
Prefix:
First Name:SERGIO
Middle Name:ANDRE
Last Name:MARTINEZ
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:5979 VINELAND RD STE 101
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32819-7860
Mailing Address - Country:US
Mailing Address - Phone:407-355-3120
Mailing Address - Fax:407-355-3119
Practice Address - Street 1:5979 VINELAND RD STE 101
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32819-7860
Practice Address - Country:US
Practice Address - Phone:407-355-3120
Practice Address - Fax:407-355-3119
Is Sole Proprietor?:No
Enumeration Date:2011-12-13
Last Update Date:2022-05-13
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLU02129207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery