Healthcare Provider Details

I. General information

NPI: 1477755668
Provider Name (Legal Business Name): JERRY MARTEL M.D., M.P.H.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/01/2007
Last Update Date: 01/15/2025
Certification Date: 01/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8950 N KENDALL DR STE 306W
MIAMI FL
33176-2132
US

IV. Provider business mailing address

9500 S DADELAND BLVD STE 200
MIAMI FL
33156-2866
US

V. Phone/Fax

Practice location:
  • Phone: 305-596-9966
  • Fax:
Mailing address:
  • Phone: 786-530-3820
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License NumberME103922
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: