Healthcare Provider Details

I. General information

NPI: 1164424719
Provider Name (Legal Business Name): MARTIN J. FREY M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/12/2005
Last Update Date: 01/04/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3661 S MIAMI AVE STE 301B
MIAMI FL
33133-4232
US

IV. Provider business mailing address

3801 BISCAYNE BLVD STE 300
MIAMI FL
33137-9800
US

V. Phone/Fax

Practice location:
  • Phone: 305-285-5666
  • Fax: 866-947-2942
Mailing address:
  • Phone: 305-571-0620
  • Fax: 305-576-8099

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License NumberME55273
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: