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NPI Code Detail

MEDICARE: AUGUSTO RAFAEL MARTINEZ M.D.

MEDICARE: AUGUSTO RAFAEL 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
1208000000XPediatrics PhysicianME 53532FL
2208000000XPediatrics PhysicianMD14410RI
3208000000XPediatrics Physician70313MA

General Provider Information

NPI Number : 1639407679
Entity Type Code : Individual
Provider Name (Legal Business Name) : AUGUSTO RAFAEL MARTINEZ M.D.
Provider Business Mailing Address
First Line : 85 GRAND ST
Second Line :
City : CANTON
State : MA
Zip : 02021-1809
Country : US
Telephone Number : 305-297-9083
Fax Number :
Provider Business Practice Location Address
First Line : 465 S WASHINGTON ST UNIT 4
Second Line :
City : NORTH ATTLEBORO
State : MA
Zip : 02760-2159
Country : US
Telephone Number : 781-562-0779
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/03/2009
Last Update Date : 03/30/2022

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