Provider Demographics
NPI:1306870977
Name:MARTINEZ, GLADYS R (DO)
Entity type:Individual
Prefix:DR
First Name:GLADYS
Middle Name:R
Last Name:MARTINEZ
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:15340 JOG RD
Mailing Address - Street 2:SUITE 202
Mailing Address - City:DELRAY BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33446-2170
Mailing Address - Country:US
Mailing Address - Phone:561-819-6700
Mailing Address - Fax:561-819-6701
Practice Address - Street 1:15340 JOG RD
Practice Address - Street 2:SUITE 202
Practice Address - City:DELRAY BEACH
Practice Address - State:FL
Practice Address - Zip Code:33446-2170
Practice Address - Country:US
Practice Address - Phone:561-819-6700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-10
Last Update Date:2010-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS7477207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
4304693OtherCIGNA
FL55126OtherBLUE CROSS BLUE SHIELD
56-2547040OtherHUMANA
FLF94431I413OtherVISTA
F94431I413OtherSUMMIT
FL4573393OtherAETNA
FL305705OtherAVMED
56-2547040OtherHEALTH CARE DISTRICT
56-2547040OtherUNITED
FL650561267OtherTAX ID
FL305705OtherAVMED