Healthcare Provider Details

I. General information

NPI: 1659015998
Provider Name (Legal Business Name): RAMON MARTINEZ
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/22/2022
Last Update Date: 06/12/2026
Certification Date: 06/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5301 S CONGRESS AVE
ATLANTIS FL
33462-1197
US

IV. Provider business mailing address

CALLE 14 D13, VILLAS DEL RIO
BAYAMON PR
00959
US

V. Phone/Fax

Practice location:
  • Phone: 561-965-7300
  • Fax:
Mailing address:
  • Phone: 787-299-8671
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberTRN39516
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: