Healthcare Provider Details

I. General information

NPI: 1841924024
Provider Name (Legal Business Name): ELIZABETH MARTINEZ MD PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/13/2022
Last Update Date: 10/14/2022
Certification Date: 10/14/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8352 SW 8TH ST
MIAMI FL
33144-4180
US

IV. Provider business mailing address

8352 SW 8TH ST
MIAMI FL
33144-4180
US

V. Phone/Fax

Practice location:
  • Phone: 305-262-8282
  • Fax:
Mailing address:
  • Phone: 305-262-8282
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number StateNULL

VIII. Authorized Official

Name: ELIZABETH MARTINEZ
Title or Position: MD/ OWNER
Credential: MD
Phone: 305-262-8282