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General NPI Number Information
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NPI Number | 1174100499
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Entity Type | Individual
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Provider Name | BRANDEN MARTINEZ DO
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Gender | Male
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Dates
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Enumeration Date | 03/24/2021
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Last Update Date | 07/24/2024
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Provider Practice Location Address
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Address Line | 300 S PARK RD STE 400
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City | HOLLYWOOD
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State | FL
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Zip | 33021-8353
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Country | US
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Telephone | 800-893-9698
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Fax |
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Provider Business Mailing Address
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Address Line | 6881 SW 130TH TER
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City | PINECREST
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State | FL
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Zip | 33156-6923
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Country | US
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Telephone | 786-457-1778
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Fax |
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | OS21112
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License Number State | FL
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