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NPI 1164465472

NPI 1164465472 : OSCAR MARTINEZ RPT : MIAMI, FL

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General NPI Number Information
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    NPI Number           |    1164465472
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    Entity Type          |    Individual 
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    Provider Name        |    OSCAR MARTINEZ RPT
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    06/14/2006
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    Last Update Date     |    05/09/2008
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Provider Practice Location Address
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    Address Line         |    2423 SW 147TH AVE 137
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    City                 |    MIAMI
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    State                |    FL
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    Zip                  |    33185-4082
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    Country              |    US
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    Telephone            |    786-271-6767
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    Fax                  |    786-271-6767
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Provider Business Mailing Address
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    Address Line         |    2423 SW 147TH AVE 137
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    City                 |    MIAMI
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    State                |    FL
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    Zip                  |    33185-4082
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    Country              |    US
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    Telephone            |    786-271-6767
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    Fax                  |    786-271-6767
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    225100000X
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    Taxonomy Name        |    Physical Therapist
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    License Number       |    PT 19308
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    License Number State |    FL
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