Provider Demographics
NPI:1962603340
Name:MARTINEZ, GABRIEL L (MD)
Entity type:Individual
Prefix:DR
First Name:GABRIEL
Middle Name:L
Last Name:MARTINEZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:12734 KENWOOD LANE
Mailing Address - Street 2:STE. 84
Mailing Address - City:FT. MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33907-5638
Mailing Address - Country:US
Mailing Address - Phone:239-936-5250
Mailing Address - Fax:239-936-9970
Practice Address - Street 1:12734 KENWOOD LANE
Practice Address - Street 2:STE. 84
Practice Address - City:FT. MYERS
Practice Address - State:FL
Practice Address - Zip Code:33907-5638
Practice Address - Country:US
Practice Address - Phone:239-936-5250
Practice Address - Fax:239-936-9970
Is Sole Proprietor?:No
Enumeration Date:2007-05-31
Last Update Date:2009-06-22
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PR25, 948-R208D00000X
FLME1028832084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice