Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 53327 | FL |
N | 111NI0900X | Internist | 53327 | FL |
Y | 207RP1001X | Pulmonary Disease | 53327 | FL |
NPI | 1003874561 |
---|---|
Provider Name | Dr. Carlos Manuel Martinez |
First Address | Homestead, FL 33030 |
Second Address | Homestead, FL 33030 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 03/05/2006 |
Last Update Date | 19/04/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
062459400 | (05) | FL |
C57910 | (02) |