MEDICARE: MISS SONIA ELENA MARTINEZ RPH

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	183500000X	Pharmacist	PS31297	FL
2	183500000X	Pharmacist	PS 31297	FL

General Provider Information

NPI Number	:	1427052356
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MISS SONIA ELENA MARTINEZ RPH

Provider Business Mailing Address
First Line	:	1407 TUNIS ST
Second Line	:
City	:	CORAL GABLES
State	:	FL
Zip	:	33134-2460
Country	:	US
Telephone Number	:	786-385-4294
Fax Number	:

Provider Business Practice Location Address
First Line	:	6627 S DIXIE HWY
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33143-7919
Country	:	US
Telephone Number	:	305-665-4411
Fax Number	:

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

Provider Enumeration Date	:	06/09/2005
Last Update Date	:	01/12/2021

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