MEDICARE: MR. CARLOS ARTURO MARTINEZ PT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	18133	MD

General Provider Information

NPI Number	:	1295815520
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. CARLOS ARTURO MARTINEZ PT

Provider Business Mailing Address
First Line	:	14205 PARK CENTER DR
Second Line	:	STE 204
City	:	LAUREL
State	:	MD
Zip	:	20707-5252
Country	:	US
Telephone Number	:	301-853-0093
Fax Number	:	301-853-0096

Provider Business Practice Location Address
First Line	:	3311 TOLEDO TER
Second Line	:	SUITE #A-1
City	:	HYATTSVILLE
State	:	MD
Zip	:	20782-4135
Country	:	US
Telephone Number	:	301-853-0093
Fax Number	:	301-853-0096

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/17/2006
Last Update Date	:	02/19/2020

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