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General NPI Number Information
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NPI Number | 1689256059
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Entity Type | Individual
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Provider Name | CHRISTIAN MARTINEZ MD
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Gender | Male
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Dates
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Enumeration Date | 04/26/2021
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Last Update Date | 09/30/2025
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Provider Practice Location Address
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Address Line | 1590 S SR 15A STE 100
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City | DELAND
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State | FL
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Zip | 32720-7817
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Country | US
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Telephone | 386-774-0016
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Fax | 386-774-0606
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Provider Business Mailing Address
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Address Line | 496 MILE POST CT
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City | LAKE MARY
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State | FL
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Zip | 32746-5119
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Country | US
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Telephone | 939-401-1971
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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 | ME167868
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License Number State | FL
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