Doctor Name: | LISA C. MARTINEZ |
NPI Number: | 1659574226 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MD |
License Number: | 0116019236 |
Business Practice Address: | 2500 N Military Trl Suite 260 Boca Raton, FL - 334316344 |
Business Phone Number: | 5618861202 |
Business Fax Number: | 5618661200 |
Mailing Address: | 2500 N Military Trl, Suite 260 BOCA RATON |
State: | FL |
Postal Code: | 334316344 |
Phone Number: | 5618861202 |
Fax Number: | 5618661200 |
NPI Enumeration Date: | 06/08/2007 |
NPI Last Update Date: | 09/18/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 390200000X |
License Number: | 0116019236 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | VA |
Taxonomy Type: | Student, Health Care |
Taxonomy Classification: | Student in an Organized Health Care Education/Training Program |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |