Provider Demographics
NPI:1538213970
Name:MARTINEZ BERMUDEZ, CLAUDIA AGUSTINA (MD)
Entity type:Individual
Prefix:
First Name:CLAUDIA
Middle Name:AGUSTINA
Last Name:MARTINEZ BERMUDEZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:CLAUDIA
Other - Middle Name:A
Other - Last Name:MARTINEZ
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:1120 NW 14TH ST
Mailing Address - Street 2:1118
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33136-2107
Mailing Address - Country:US
Mailing Address - Phone:305-243-2699
Mailing Address - Fax:305-836-2654
Practice Address - Street 1:777 E 25TH ST
Practice Address - Street 2:ROOM 118
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33013-3825
Practice Address - Country:US
Practice Address - Phone:305-243-2699
Practice Address - Fax:305-836-2654
Is Sole Proprietor?:No
Enumeration Date:2007-01-23
Last Update Date:2018-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME97773207RC0000X, 207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLME97773OtherSTATE LICENSE
FLME97773OtherSTATE LICENSE