Healthcare Provider Details

I. General information

NPI: 1316927080
Provider Name (Legal Business Name): DANIEL MARTINEZ URTARTE MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/19/2006
Last Update Date: 02/03/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1400 NW 12TH AVE STE 405 EMERGENCY DEPARTMENT
MIAMI FL
33136-1003
US

IV. Provider business mailing address

PO BOX 534221
ATLANTA GA
30353-4221
US

V. Phone/Fax

Practice location:
  • Phone: 305-547-6468
  • Fax: 305-547-6469
Mailing address:
  • Phone: 305-651-2270
  • Fax: 904-346-0113

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberME0070730
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: