Healthcare Provider Details

I. General information

NPI: 1114141132
Provider Name (Legal Business Name): ALEJANDRO LAZARO MARTINEZ M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/12/2007
Last Update Date: 08/24/2026
Certification Date: 08/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4430 14TH ST W
BRADENTON FL
34207-1425
US

IV. Provider business mailing address

102 WOODMONT BLVD STE 600
NASHVILLE TN
37205-5250
US

V. Phone/Fax

Practice location:
  • Phone: 941-297-2123
  • Fax: 941-297-2210
Mailing address:
  • Phone: 888-987-1151
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberME100604
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: