Provider Demographics
NPI:1063523439
Name:MARTINEZ-ANGEL, ROCIO (MD)
Entity type:Individual
Prefix:DR
First Name:ROCIO
Middle Name:
Last Name:MARTINEZ-ANGEL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:ROCIO
Other - Middle Name:DE LOS ANGELES
Other - Last Name:MARTINEZ-ANGEL
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:5333 N DIXIE HWY STE 106
Mailing Address - Street 2:
Mailing Address - City:OAKLAND PARK
Mailing Address - State:FL
Mailing Address - Zip Code:33334-3453
Mailing Address - Country:US
Mailing Address - Phone:954-771-4747
Mailing Address - Fax:954-491-6841
Practice Address - Street 1:5333 N DIXIE HWY STE 106
Practice Address - Street 2:
Practice Address - City:OAKLAND PARK
Practice Address - State:FL
Practice Address - Zip Code:33334-3453
Practice Address - Country:US
Practice Address - Phone:954-771-4747
Practice Address - Fax:954-491-6841
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2015-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME90151208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL270163400Medicaid