Provider Demographics
NPI:1275666737
Name:MARTINEZ-FORTUN, BERTA (MD)
Entity type:Individual
Prefix:MRS
First Name:BERTA
Middle Name:
Last Name:MARTINEZ-FORTUN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3850 COCONUT CREEK PKWY STE 3
Mailing Address - Street 2:
Mailing Address - City:COCONUT CREEK
Mailing Address - State:FL
Mailing Address - Zip Code:33066-1600
Mailing Address - Country:US
Mailing Address - Phone:954-973-9222
Mailing Address - Fax:954-973-7135
Practice Address - Street 1:3850 COCONUT CREEK PKWY STE 3
Practice Address - Street 2:
Practice Address - City:COCONUT CREEK
Practice Address - State:FL
Practice Address - Zip Code:33066-1600
Practice Address - Country:US
Practice Address - Phone:954-973-9222
Practice Address - Fax:954-973-7135
Is Sole Proprietor?:No
Enumeration Date:2007-03-13
Last Update Date:2025-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME175325207Q00000X
FLPA9103057363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant