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General NPI Number Information
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NPI Number | 1699733972
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Entity Type | Individual
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Provider Name | JOSE L MARTINEZ MD PA MD
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Gender | Male
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Dates
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Enumeration Date | 05/03/2006
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Last Update Date | 11/19/2008
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Provider Practice Location Address
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Address Line | 3319 STATE ROAD 7 STE 215
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City | WELLINGTON
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State | FL
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Zip | 33449-8092
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Country | US
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Telephone | 561-791-1630
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Fax |
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Provider Business Mailing Address
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Address Line | 3319 STATE ROAD 7 SUITE 215
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City | WELLINGTON
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State | FL
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Zip | 33449-8094
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Country | US
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Telephone | 561-791-1630
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | ME0056575
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License Number State | FL
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