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NPI Code Detail

MEDICARE: DR. BIANKA MARTINEZ DO

MEDICARE: DR. BIANKA MARTINEZ DO
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 Physician81514-21WI
2390200000XStudent in an Organized Health Care Education/Training Program
3208000000XPediatrics Physician125.078701IL

General Provider Information

NPI Number : 1710563234
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. BIANKA MARTINEZ DO
Provider Business Mailing Address
First Line : 840 S WOOD ST RM 1403
Second Line :
City : CHICAGO
State : IL
Zip : 60612-4325
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 4855 S MOORLAND RD FL 3
Second Line :
City : NEW BERLIN
State : WI
Zip : 53151-7494
Country : US
Telephone Number : 262-432-7599
Fax Number : 262-432-7694
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/23/2021
Last Update Date : 04/14/2025

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Directions to “ DR. BIANKA MARTINEZ DO” Practice Location

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