Healthcare Provider Details

I. General information

NPI: 1134505787
Provider Name (Legal Business Name): RACHEL MARTINEZ
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/05/2015
Last Update Date: 07/30/2024
Certification Date: 07/30/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7306 SW 117TH AVE
MIAMI FL
33183-3804
US

IV. Provider business mailing address

1654 SW 138TH CT
MIAMI FL
33175-7537
US

V. Phone/Fax

Practice location:
  • Phone: 305-220-0220
  • Fax: 305-220-0610
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WG0000X
TaxonomyGeneral Practice Registered Nurse
License NumberRN9305033
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberARNP9305033
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: