Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207V00000X | Obstetrician & Gynecologist | ME54659 | FL |
NPI | 1013946458 |
---|---|
Provider Name | Rebeca Caridad Martinez |
First Address | Miami, FL 33133-4227 |
Second Address | Miami, FL 33133-4227 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 30/06/2006 |
Last Update Date | 26/11/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
02077 | BCBS (01) | FL |
201600506 | TAX ID (01) | FL |
208792 | AVMED (01) | FL |
E53962 | (02) | FL |