Provider Demographics
NPI:1548693260
Name:MARTINEZ, JUAN (RT)
Entity type:Individual
Prefix:
First Name:JUAN
Middle Name:
Last Name:MARTINEZ
Suffix:
Gender:M
Credentials:RT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6238 GRANT ST
Mailing Address - Street 2:
Mailing Address - City:HOLLYWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:33024-5941
Mailing Address - Country:US
Mailing Address - Phone:786-512-4013
Mailing Address - Fax:
Practice Address - Street 1:6238 GRANT ST
Practice Address - Street 2:
Practice Address - City:HOLLYWOOD
Practice Address - State:FL
Practice Address - Zip Code:33024-5941
Practice Address - Country:US
Practice Address - Phone:786-512-4013
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-16
Last Update Date:2013-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL154002279H0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2279H0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, RegisteredHome Health