Provider Demographics
NPI:1588369581
Name:MARTELL RODRIGUEZ, CHRISTIANE YURANI (MD)
Entity type:Individual
Prefix:
First Name:CHRISTIANE
Middle Name:YURANI
Last Name:MARTELL RODRIGUEZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 PARKVIEW PL
Mailing Address - Street 2:
Mailing Address - City:LAKELAND
Mailing Address - State:FL
Mailing Address - Zip Code:33805-4550
Mailing Address - Country:US
Mailing Address - Phone:863-687-1300
Mailing Address - Fax:
Practice Address - Street 1:11512 CITRA CIR APT 305
Practice Address - Street 2:
Practice Address - City:WINDERMERE
Practice Address - State:FL
Practice Address - Zip Code:34786-5981
Practice Address - Country:US
Practice Address - Phone:407-725-0278
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-31
Last Update Date:2023-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL0000000207R00000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine