Provider Demographics
NPI:1427268929
Name:MARTINEZ, JORGE LUIS JR (PHARM D)
Entity type:Individual
Prefix:DR
First Name:JORGE
Middle Name:LUIS
Last Name:MARTINEZ
Suffix:JR
Gender:M
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:7800 NW 201ST TER
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33015-5997
Mailing Address - Country:US
Mailing Address - Phone:305-541-8699
Mailing Address - Fax:305-541-8696
Practice Address - Street 1:1835 W FLAGLER ST
Practice Address - Street 2:204
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33135-1917
Practice Address - Country:US
Practice Address - Phone:305-541-8699
Practice Address - Fax:305-541-8696
Is Sole Proprietor?:No
Enumeration Date:2007-05-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS35063183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist