Healthcare Provider Details

I. General information

NPI: 1629535760
Provider Name (Legal Business Name): ARGELIO A MARTINEZ APRN
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/25/2019
Last Update Date: 10/11/2022
Certification Date: 10/11/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12320 QUAIL ROOST DR
MIAMI FL
33177-4930
US

IV. Provider business mailing address

6100 BLUE LAGOON DR STE 365
MIAMI FL
33126-7010
US

V. Phone/Fax

Practice location:
  • Phone: 786-623-0994
  • Fax: 786-430-8197
Mailing address:
  • Phone: 786-322-7333
  • Fax: 786-347-6022

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberAPRN11000675
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: