Healthcare Provider Details

I. General information

NPI: 1104104264
Provider Name (Legal Business Name): OSCAR MARTINEZ LOPEZ M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/23/2011
Last Update Date: 10/05/2026
Certification Date: 10/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 SE OCEAN BLVD STE A
STUART FL
34994-2448
US

IV. Provider business mailing address

800 SE OCEAN BLVD STE A
STUART FL
34994-2448
US

V. Phone/Fax

Practice location:
  • Phone: 216-778-0423
  • Fax: 216-548-4735
Mailing address:
  • Phone: 772-335-4234
  • Fax: 772-335-4236

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number57018996
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code207RI0200X
TaxonomyInfectious Disease Physician
License NumberME119592
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License NumberME0119592
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: