Healthcare Provider Details

I. General information

NPI: 1548186489
Provider Name (Legal Business Name): MARTIN RUBEN INFANTE ALTAMIRANO M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/25/2026
Last Update Date: 06/25/2026
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5301 S CONGRESS AVE JFK HOSPITAL
ATLANTIS FL
33462
US

IV. Provider business mailing address

CALLE SANTA ELENA NORTE 155 E604
LIMA LIMA
15023
PE

V. Phone/Fax

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

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: