Provider Demographics
NPI:1992576532
Name:MARTINEZ, GIOVANNI SR
Entity type:Individual
Prefix:
First Name:GIOVANNI
Middle Name:
Last Name:MARTINEZ
Suffix:SR
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 1:4607 IRENE LOOP
Mailing Address - Street 2:
Mailing Address - City:NEW PORT RICHEY
Mailing Address - State:FL
Mailing Address - Zip Code:34652-4810
Mailing Address - Country:US
Mailing Address - Phone:813-784-2338
Mailing Address - Fax:
Practice Address - Street 1:4607 IRENE LOOP
Practice Address - Street 2:
Practice Address - City:NEW PORT RICHEY
Practice Address - State:FL
Practice Address - Zip Code:34652-4810
Practice Address - Country:US
Practice Address - Phone:813-784-2338
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-11
Last Update Date:2024-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory