Healthcare Provider Details

I. General information

NPI: 1982329348
Provider Name (Legal Business Name): DR ABELARDO BROCETA MARTINEZ MD P.A
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/07/2022
Last Update Date: 03/10/2023
Certification Date: 03/10/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1475 W 49TH ST
HIALEAH FL
33012-3222
US

IV. Provider business mailing address

8880 SW 8TH ST # 1371
MIAMI FL
33144-3526
US

V. Phone/Fax

Practice location:
  • Phone: 305-916-9215
  • Fax:
Mailing address:
  • Phone: 305-916-9215
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. ABELARDO BROCETA MARTINEZ
Title or Position: OWNER/CEO
Credential: MD
Phone: 305-915-9215