Provider Demographics
NPI:1538156328
Name:MARTINEZ CATINCHI, FERNANDO LUIS (MD)
Entity type:Individual
Prefix:DR
First Name:FERNANDO
Middle Name:LUIS
Last Name:MARTINEZ CATINCHI
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 1:7100 W 20TH AVE
Mailing Address - Street 2:SUITE 402
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33016-1897
Mailing Address - Country:US
Mailing Address - Phone:305-557-9552
Mailing Address - Fax:305-558-6731
Practice Address - Street 1:7100 W 20TH AVE
Practice Address - Street 2:SUITE 402
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33016-1897
Practice Address - Country:US
Practice Address - Phone:305-557-9552
Practice Address - Fax:305-558-6731
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL33884174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL95209Medicare ID - Type Unspecified
FLD49747Medicare UPIN