Individual
IAN R MARTINEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2572 W STATE ROAD 426 STE 1000, OVIEDO, FL 32765-8389
(407) 478-0882
Mailing address
2572 W STATE ROAD 426 STE 1000, OVIEDO, FL 32765-8389
(407) 478-0882
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
20601
PR
207RG0100X
Gastroenterology Physician
MD.203345
LA
207RG0100X
Gastroenterology Physician
Primary
ME130998
FL
208D00000X
General Practice Physician
20601
PR
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
09379218
—
MS
05
—
1006190
—
LA
Enumeration date
08/07/2007
Last updated
05/16/2021
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