Healthcare Provider Details

I. General information

NPI: 1013985803
Provider Name (Legal Business Name): GUILLERMO A MARTINEZ-REYES M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: DR. GUILLERMO A. MARTINEZ

II. Dates (important events)

Enumeration Date: 03/09/2006
Last Update Date: 03/07/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5975 SUNSET DR STE 405
SOUTH MIAMI FL
33143-5198
US

IV. Provider business mailing address

5975 SUNSET DR STE 405
SOUTH MIAMI FL
33143-5198
US

V. Phone/Fax

Practice location:
  • Phone: 305-661-8040
  • Fax: 305-661-8891
Mailing address:
  • Phone: 305-661-8040
  • Fax: 305-661-8891

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License NumberME41300
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: