Healthcare Provider Details

I. General information

NPI: 1588352876
Provider Name (Legal Business Name): JUAN RICARDO MARTINEZ DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/26/2023
Last Update Date: 07/15/2026
Certification Date: 07/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13600 IMMOKALEE RD UNIT 102
NAPLES FL
34120-7593
US

IV. Provider business mailing address

14948 INDIGO LAKES DR
NAPLES FL
34119-4800
US

V. Phone/Fax

Practice location:
  • Phone: 239-234-2515
  • Fax:
Mailing address:
  • Phone: 305-676-1724
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License NumberDN28420
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: