MEDICARE: JOSE LUIS MARTINEZ M.D.

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	207RG0100X	Gastroenterology Physician	ME0065252	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	28194	OTHER	FL	BC/BS
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1508853490
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOSE LUIS MARTINEZ M.D.

Provider Business Mailing Address
First Line	:	2140 W 68TH ST
Second Line	:	STE 300
City	:	HIALEAH
State	:	FL
Zip	:	33016-1815
Country	:	US
Telephone Number	:	305-822-4108
Fax Number	:	786-497-2989

Provider Business Practice Location Address
First Line	:	2140 W 68TH ST
Second Line	:	SUITE 300
City	:	HIALEAH
State	:	FL
Zip	:	33016-1815
Country	:	US
Telephone Number	:	305-822-4108
Fax Number	:	305-822-5086

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

Provider Enumeration Date	:	10/05/2005
Last Update Date	:	07/27/2016

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Directions to “ JOSE LUIS MARTINEZ M.D.” Practice Location

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