MEDICARE: JOSE R MARTIN SR MD MPS PA

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	208D00000X	General Practice Physician

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1427122829
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JOSE R MARTIN SR MD MPS PA

Provider Business Mailing Address
First Line	:	3970 W FLAGLER ST
Second Line	:	SUITE 101
City	:	CORAL GABLES
State	:	FL
Zip	:	33134-1642
Country	:	US
Telephone Number	:	305-608-7883
Fax Number	:

Provider Business Practice Location Address
First Line	:	3970 W FLAGLER ST
Second Line	:	SUITE 101
City	:	CORAL GABLES
State	:	FL
Zip	:	33134-1642
Country	:	US
Telephone Number	:	305-608-7883
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. JOSE R MARTIN SR.
Credential	:	MD
Telephone Number	:	305-608-7883

Provider Enumeration Date	:	11/17/2006
Last Update Date	:	02/21/2012

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