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General NPI Number Information
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NPI Number | 1598487472
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Entity Type | Individual
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Provider Name | HERIBERTO MARTINEZ JR. PHARM.D.
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Gender | Male
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Dates
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Enumeration Date | 09/16/2022
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Last Update Date | 09/16/2022
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Provider Practice Location Address
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Address Line | 2021 S ORANGE AVE
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City | ORLANDO
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State | FL
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Zip | 32806-3035
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Country | US
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Telephone | 407-730-3557
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Fax | 407-730-3560
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Provider Business Mailing Address
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Address Line | 12159 STONE BARK TRL
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City | ORLANDO
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State | FL
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Zip | 32824-7331
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Country | US
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Telephone | 407-462-2442
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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 | 183500000X
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Taxonomy Name | Pharmacist
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License Number | PS43091
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License Number State | FL
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