Provider Demographics
NPI:1306542949
Name:MARTINEZ, MICHAEL ALEXANDER (DC)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:ALEXANDER
Last Name:MARTINEZ
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6120 REESE RD APT 307
Mailing Address - Street 2:
Mailing Address - City:DAVIE
Mailing Address - State:FL
Mailing Address - Zip Code:33314-1258
Mailing Address - Country:US
Mailing Address - Phone:954-761-6191
Mailing Address - Fax:
Practice Address - Street 1:1857 NE MIAMI GARDENS DR
Practice Address - Street 2:
Practice Address - City:NORTH MIAMI BEACH
Practice Address - State:FL
Practice Address - Zip Code:33179-5035
Practice Address - Country:US
Practice Address - Phone:305-940-6161
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-02-06
Last Update Date:2023-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH14384111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor