Healthcare Provider Details

I. General information

NPI: 1689860421
Provider Name (Legal Business Name): AXEL E. MARTINEZ IRIZARRY M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/14/2007
Last Update Date: 12/03/2024
Certification Date: 12/03/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3610 E FORT KING ST
OCALA FL
34470-1319
US

IV. Provider business mailing address

3610 E FORT KING ST
OCALA FL
34470-1319
US

V. Phone/Fax

Practice location:
  • Phone: 352-421-5681
  • Fax: 844-927-4812
Mailing address:
  • Phone: 352-421-5681
  • Fax: 844-927-4812

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberME127807
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number17055
License Number StatePR
# 3
Primary TaxonomyN
Taxonomy Code207QG0300X
TaxonomyGeriatric Medicine (Family Medicine) Physician
License NumberME127807
License Number StateFL
# 4
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberN5844
License Number StateTX
# 5
Primary TaxonomyN
Taxonomy Code207QG0300X
TaxonomyGeriatric Medicine (Family Medicine) Physician
License Number17055
License Number StatePR
# 6
Primary TaxonomyN
Taxonomy Code207QG0300X
TaxonomyGeriatric Medicine (Family Medicine) Physician
License NumberN5844
License Number StateTX
# 7
Primary TaxonomyN
Taxonomy Code207QH0002X
TaxonomyHospice and Palliative Medicine (Family Medicine) Physician
License NumberME127807
License Number StateFL
# 8
Primary TaxonomyN
Taxonomy Code207QH0002X
TaxonomyHospice and Palliative Medicine (Family Medicine) Physician
License NumberN5844
License Number StateTX
# 9
Primary TaxonomyN
Taxonomy Code207QH0002X
TaxonomyHospice and Palliative Medicine (Family Medicine) Physician
License Number17055
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: