MEDICARE: JUAN CARLOS MARTINEZ MD

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	2080P0214X	Pediatric Pulmonology Physician	ME68828	FL

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	:	1619963287
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JUAN CARLOS MARTINEZ MD

Provider Business Mailing Address
First Line	:	5955 PONCE DE LEON BLVD
Second Line	:
City	:	CORAL GABLES
State	:	FL
Zip	:	33146-2423
Country	:	US
Telephone Number	:	305-661-1515
Fax Number	:

Provider Business Practice Location Address
First Line	:	3200 SW 60TH CT STE 203
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33155-4070
Country	:	US
Telephone Number	:	305-662-8380
Fax Number	:	866-832-5324

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

Provider Enumeration Date	:	09/20/2005
Last Update Date	:	09/05/2025

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