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NPI Code Detail

MEDICARE: DR. JUAN MARTINEZ-ROSS MD

MEDICARE: DR. JUAN MARTINEZ-ROSS 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
1207R00000XInternal Medicine Physician11540998-1205UT

General Provider Information

NPI Number : 1720139538
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JUAN MARTINEZ-ROSS MD
Provider Business Mailing Address
First Line : 2965 W 3500 S
Second Line :
City : WEST VALLEY CITY
State : UT
Zip : 84119-3602
Country : US
Telephone Number : 801-965-3600
Fax Number :
Provider Business Practice Location Address
First Line : 1160 E 3900 S STE 1000
Second Line :
City : SALT LAKE CITY
State : UT
Zip : 84124-1233
Country : US
Telephone Number : 801-262-1771
Fax Number : 801-288-9101
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/16/2007
Last Update Date : 03/12/2026

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Directions to “ DR. JUAN MARTINEZ-ROSS MD” Practice Location

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