MEDICARE: CLARISOL M MARTINEZ M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	ME86060	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	ME86060	OTHER	FL	MEDICAL LICENSE NUMBER
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1811988512
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CLARISOL M MARTINEZ M.D.

Provider Business Mailing Address
First Line	:	4881 NW 8TH AVE
Second Line	:	SUITE 2
City	:	GAINESVILLE
State	:	FL
Zip	:	32605-4582
Country	:	US
Telephone Number	:	352-373-6338
Fax Number	:	352-373-6144

Provider Business Practice Location Address
First Line	:	4343 W NEWBERRY RD
Second Line	:	SUITE 13
City	:	GAINESVILLE
State	:	FL
Zip	:	32607-2817
Country	:	US
Telephone Number	:	352-332-7770
Fax Number	:	352-224-2482

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/02/2005
Last Update Date	:	03/15/2012

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Directions to “ CLARISOL M MARTINEZ M.D.” Practice Location

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