Provider Demographics
NPI:1124277520
Name:MARTINEZ, ARNALDO M (OD)
Entity type:Individual
Prefix:DR
First Name:ARNALDO
Middle Name:M
Last Name:MARTINEZ
Suffix:
Gender:M
Credentials:OD
Other - Prefix:DR
Other - First Name:ARNALDO
Other - Middle Name:MANUEL
Other - Last Name:MARTINEZ
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:OD
Mailing Address - Street 1:PO BOX 827082
Mailing Address - Street 2:
Mailing Address - City:PEMBROKE PINES
Mailing Address - State:FL
Mailing Address - Zip Code:33082-7082
Mailing Address - Country:US
Mailing Address - Phone:954-364-7499
Mailing Address - Fax:954-874-6238
Practice Address - Street 1:11826 MIRAMAR PKWY UNIT A
Practice Address - Street 2:
Practice Address - City:MIRAMAR
Practice Address - State:FL
Practice Address - Zip Code:33025-5800
Practice Address - Country:US
Practice Address - Phone:954-364-7499
Practice Address - Fax:954-874-6238
Is Sole Proprietor?:No
Enumeration Date:2008-09-10
Last Update Date:2024-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOPC4346152W00000X, 152WP0200X, 152WX0102X, 152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
No152WP0200XEye and Vision Services ProvidersOptometristPediatrics
No152WX0102XEye and Vision Services ProvidersOptometristOccupational Vision
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL000897400Medicaid
FLOPC 4346OtherMEDICAL LICENSE
20224OtherBLUE CROSS BLUE SHIELD
FL000897400Medicaid