Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207V00000X | Obstetrician & Gynecologist | ME150252 | FL |
NPI | 1013380609 |
---|---|
Provider Name | Carlos Luis Martinez |
First Address | Brooklyn, NY 11214-6126 |
Second Address | Miami, FL 33183-4826 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 04/11/2015 |
Last Update Date | 30/04/2021 |