Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | ME118039 | FL |
Y | 2080P0203X | Pediatric Critical Care Doctor | ME118039 | FL |
NPI | 1164504783 |
---|---|
Provider Name | Dr. Paul A Martinez |
First Address | Miami, FL 33155-3009 |
Second Address | Miami, FL 33155-3009 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/10/2006 |
Last Update Date | 01/02/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1971388 | (05) | NY |
H00594 | (02) | NY |