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General NPI Number Information
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NPI Number | 1255248571
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Entity Type | Organization
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Legal Business Name | IDEL MEDICAL RESEARCH GROUP, INC.
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Dates
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Enumeration Date | 08/24/2026
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Last Update Date | 08/24/2026
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Provider Practice Location Address
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Address Line | 14100 PALMETTO FRNTG RD STE 107
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City | MIAMI LAKES
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State | FL
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Zip | 33016-1568
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Country | US
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Telephone | 305-488-4591
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Fax | 305-488-0438
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Provider Business Mailing Address
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Address Line | 14100 PALMETTO FRNTG RD STE 107
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City | MIAMI LAKES
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State | FL
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Zip | 33016-1568
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Country | US
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Telephone | 305-488-4591
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Fax | 305-488-0438
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Authorized Official
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Title or Position | OWNER
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Name | DIANELYS MARTINEZ
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Credential | APRN
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Telephone | 305-488-4591
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number |
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License Number State |
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