Provider Demographics
NPI:1699747188
Name:MARTINEZ, KIM S (MD)
Entity type:Individual
Prefix:DR
First Name:KIM
Middle Name:S
Last Name:MARTINEZ
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Gender:F
Credentials:MD
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Mailing Address - Street 1:7200 CORPORATE CENTER DR
Mailing Address - Street 2:#600
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33126-1200
Mailing Address - Country:US
Mailing Address - Phone:305-500-2000
Mailing Address - Fax:305-500-2145
Practice Address - Street 1:7101 W MCNAB RD
Practice Address - Street 2:#101
Practice Address - City:TAMARAC
Practice Address - State:FL
Practice Address - Zip Code:33321-5351
Practice Address - Country:US
Practice Address - Phone:954-722-5600
Practice Address - Fax:954-721-7790
Is Sole Proprietor?:No
Enumeration Date:2006-02-07
Last Update Date:2010-05-20
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Provider Licenses
StateLicense IDTaxonomies
FLME87092207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02793988Medicaid
NYH57672Medicare UPIN
NY43V971Medicare PIN