Healthcare Provider Details

I. General information

NPI: 1174823751
Provider Name (Legal Business Name): JUVENAL E. MARTINEZ, MD, PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/28/2010
Last Update Date: 05/11/2026
Certification Date: 05/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8900 SW 117TH AVE SUITE C203
MIAMI FL
33186-2175
US

IV. Provider business mailing address

8900 SW 117TH AVE STE C203
MIAMI FL
33186-2156
US

V. Phone/Fax

Practice location:
  • Phone: 305-598-6696
  • Fax: 305-598-7491
Mailing address:
  • Phone: 305-598-6696
  • Fax: 305-598-7491

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number40592
License Number StateFL

VIII. Authorized Official

Name: JUVENAL EUGENIO MARTINEZ
Title or Position: OWNER
Credential: MD
Phone: 305-598-6696