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General NPI Number Information
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NPI Number | 1912906355
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Entity Type | Individual
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Provider Name | HUMBERTO SERGIO MARTINEZ C.PH.
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Gender | Male
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Dates
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Enumeration Date | 07/19/2005
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Last Update Date | 11/19/2009
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Provider Practice Location Address
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Address Line | 11865 SW 26TH ST
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City | MIAMI
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State | FL
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Zip | 33175-2400
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Country | US
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Telephone | 305-227-0023
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Fax | 305-227-3021
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Provider Business Mailing Address
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Address Line | 14217 SW 45TH ST
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City | MIAMI
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State | FL
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Zip | 33175-4316
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Country | US
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Telephone | 305-559-0638
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Fax | 305-553-3511
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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 | PS17813
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License Number State | FL
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