Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 152W00000X | Optometrist | OPC4346 | FL |
N | 152WC0802X | Optomitrist - Corneal and Contact Lenses | OPC4346 | FL |
N | 152WP0200X | Pediatric Optomitrist | OPC4346 | FL |
N | 152WX0102X | Occupational Vision | OPC4346 | FL |
NPI | 1124277520 |
---|---|
Provider Name | Arnaldo M Martinez |
First Address | Pembroke Pines, FL 33082-7082 |
Second Address | Miramar, FL 33025-5800 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/09/2008 |
Last Update Date | 11/12/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000897400 | (05) | FL |
BN745Z | MEDICARE PIN (01) | FL |
MM3382962 | DEA (01) | WA |
OPC 4346 | MEDICAL LICENSE (01) | FL |