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NPI Code Detail

MEDICARE: GRACIELA A MARTINEZ M.D.

MEDICARE: GRACIELA A 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 PhysicianME0060897FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1750388054
Entity Type Code : Individual
Provider Name (Legal Business Name) : GRACIELA A MARTINEZ M.D.
Provider Business Mailing Address
First Line : 5900 S JOHN YOUNG PKWY
Second Line :
City : ORLANDO
State : FL
Zip : 32839-3716
Country : US
Telephone Number : 407-398-6470
Fax Number : 407-894-6872
Provider Business Practice Location Address
First Line : 5900 S JOHN YOUNG PKWY
Second Line :
City : ORLANDO
State : FL
Zip : 32839-3716
Country : US
Telephone Number : 407-398-6470
Fax Number : 407-894-6872
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/30/2005
Last Update Date : 03/22/2017

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