Provider Demographics
NPI:1962771386
Name:MARTINEZ, LEANDRO ARIEL (MD)
Entity type:Individual
Prefix:
First Name:LEANDRO
Middle Name:ARIEL
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 1:1484 AVON LN
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:NORTH LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33068-5584
Mailing Address - Country:US
Mailing Address - Phone:646-358-7059
Mailing Address - Fax:801-463-7341
Practice Address - Street 1:144 S 500 E
Practice Address - Street 2:2ND FLOOR
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84102-1907
Practice Address - Country:US
Practice Address - Phone:646-358-7059
Practice Address - Fax:801-463-7341
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-14
Last Update Date:2021-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME115017207R00000X
UT9045511-1205208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine