Healthcare Provider Details

I. General information

NPI: 1205026648
Provider Name (Legal Business Name): MARIA JULIANA ROCA MARTINEZ MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/01/2007
Last Update Date: 04/13/2022
Certification Date: 04/07/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3215 MCCLURE BRIDGE RD
DULUTH GA
30096-3223
US

IV. Provider business mailing address

1856 THOMPSON BRIDGE RD STE 5
GAINESVILLE GA
30501-1663
US

V. Phone/Fax

Practice location:
  • Phone: 678-312-6000
  • Fax: 678-312-6015
Mailing address:
  • Phone: 770-539-3374
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number059750
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: