Provider Demographics
NPI:1568274033
Name:MARTINEZ, ROBERT ANTHONY
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:ANTHONY
Last Name:MARTINEZ
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:512 PAGEWOOD DR
Mailing Address - Street 2:
Mailing Address - City:NEWPORT NEWS
Mailing Address - State:VA
Mailing Address - Zip Code:23602-4220
Mailing Address - Country:US
Mailing Address - Phone:813-453-6656
Mailing Address - Fax:
Practice Address - Street 1:1 U S COAST GUARD TRN CTR
Practice Address - Street 2:
Practice Address - City:YORKTOWN
Practice Address - State:VA
Practice Address - Zip Code:23690-5001
Practice Address - Country:US
Practice Address - Phone:813-453-6656
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-01-22
Last Update Date:2025-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1710I1003XOther Service ProvidersMilitary Health Care ProviderIndependent Duty Medical Technicians