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General NPI Number Information
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NPI Number | 1205348216
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Entity Type | Individual
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Provider Name | JOEL ANTONIO MARTINEZ RIVERA DC
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Gender | Male
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Dates
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Enumeration Date | 10/31/2017
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Last Update Date | 06/20/2024
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Provider Practice Location Address
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Address Line | 1210 E OSCEOLA PKWY STE 302
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City | KISSIMMEE
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State | FL
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Zip | 34744-1621
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Country | US
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Telephone | 407-801-0101
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Fax | 407-807-0008
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Provider Business Mailing Address
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Address Line | 1210 E OSCEOLA PKWY STE 302
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City | KISSIMMEE
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State | FL
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Zip | 34744-1621
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Country | US
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Telephone | 386-801-4184
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Fax | 407-807-0008
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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 | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | CH12283
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License Number State | FL
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