Provider Demographics
NPI:1528122918
Name:MARTINEZ, RAMON E (MD)
Entity type:Individual
Prefix:DR
First Name:RAMON
Middle Name:E
Last Name:MARTINEZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 SW 129TH AVE STE 105
Mailing Address - Street 2:
Mailing Address - City:PEMBROKE PINES
Mailing Address - State:FL
Mailing Address - Zip Code:33027-1716
Mailing Address - Country:US
Mailing Address - Phone:954-368-9141
Mailing Address - Fax:954-451-0836
Practice Address - Street 1:1 SW 129TH AVE STE 105
Practice Address - Street 2:
Practice Address - City:PEMBROKE PINES
Practice Address - State:FL
Practice Address - Zip Code:33027-1716
Practice Address - Country:US
Practice Address - Phone:954-368-9141
Practice Address - Fax:954-451-0836
Is Sole Proprietor?:No
Enumeration Date:2006-12-20
Last Update Date:2021-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME88961207R00000X, 207RG0300X, 207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL278879900Medicaid
FL278879900Medicaid