Healthcare Provider Details

I. General information

NPI: 1033773635
Provider Name (Legal Business Name): ANA HILDA MARTINEZ MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/29/2019
Last Update Date: 06/11/2026
Certification Date: 06/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3800 RESERVOIR RD NW
WASHINGTON DC
20007-2113
US

IV. Provider business mailing address

1415 N TAFT ST APT 894
ARLINGTON VA
22201-2668
US

V. Phone/Fax

Practice location:
  • Phone: 305-975-6979
  • Fax:
Mailing address:
  • Phone: 305-975-6979
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberME162659
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberCS2100014197
License Number StateDC
# 3
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number125.075561
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: