Provider Demographics
NPI:1215689989
Name:PEDRO MARTINEZ-CLARK MD PA
Entity type:Organization
Organization Name:PEDRO MARTINEZ-CLARK MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:PEDRO
Authorized Official - Middle Name:O
Authorized Official - Last Name:MARTINEZ-CLARK
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:305-249-5666
Mailing Address - Street 1:5040 NW 7TH ST STE 750
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33126-3490
Mailing Address - Country:US
Mailing Address - Phone:305-301-7169
Mailing Address - Fax:866-397-9493
Practice Address - Street 1:7725 NW 48TH ST STE 100
Practice Address - Street 2:
Practice Address - City:DORAL
Practice Address - State:FL
Practice Address - Zip Code:33166-5478
Practice Address - Country:US
Practice Address - Phone:305-640-5967
Practice Address - Fax:786-401-6574
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-01-24
Last Update Date:2022-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional CardiologyGroup - Single Specialty