MEDICARE: SANTIAGO E. MARTINEZ, M.D., 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	207K00000X	Allergy & Immunology Physician

General Provider Information

NPI Number	:	1558382119
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SANTIAGO E. MARTINEZ, M.D., PA

Provider Business Mailing Address
First Line	:	PO BOX 816
Second Line	:
City	:	GOLDENROD
State	:	FL
Zip	:	32733-0816
Country	:	US
Telephone Number	:	407-203-2301
Fax Number	:	407-203-2315

Provider Business Practice Location Address
First Line	:	12315 LAKE UNDERHILL RD
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32828-4507
Country	:	US
Telephone Number	:	407-203-2301
Fax Number	:	407-203-2315

Authorized Official
Title or Position	:	PRESIDENT/OWNER
Name	:	SANTIAGO MARTINEZ
Credential	:	MD
Telephone Number	:	407-203-2301

Provider Enumeration Date	:	07/21/2006
Last Update Date	:	06/17/2020

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