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General NPI Number Information
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NPI Number | 1922211754
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Entity Type | Individual
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Provider Name | AXEL MARTINEZ-NEGRON DMD
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Gender | Male
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Dates
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Enumeration Date | 05/08/2007
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Last Update Date | 04/26/2023
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Provider Practice Location Address
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Address Line | 2654 N ANDREWS AVE STE 4
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City | WILTON MANORS
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State | FL
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Zip | 33311-2566
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Country | US
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Telephone | 954-567-3311
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Fax | 954-567-3361
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Provider Business Mailing Address
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Address Line | 1380 SE PALM BEACH RD
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City | PORT SAINT LUCIE
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State | FL
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Zip | 34952-5318
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Country | US
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Telephone | 954-895-3309
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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 | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | DN14509
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License Number State | FL
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