Healthcare Provider Details

I. General information

NPI: 1295500122
Provider Name (Legal Business Name): HAROLD IPARRAGUIRRE MARTINEZ
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/21/2023
Last Update Date: 08/27/2025
Certification Date: 08/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3780 W FLAGLER ST
CORAL GABLES FL
33134-1602
US

IV. Provider business mailing address

3780 W FLAGLER ST
CORAL GABLES FL
33134-1602
US

V. Phone/Fax

Practice location:
  • Phone: 786-534-3772
  • Fax: 786-534-3773
Mailing address:
  • Phone: 786-534-3772
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number11029795
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: