Active NPI
Jennifer A Martinez, PA
- Clinical & Laboratory Dermatological Immunology Physician
- Miami, FL
National Provider Identifier
1184814071
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical & Laboratory Dermatological Immunology Physician
- License
- PA 9104126
- Practice address
- 7700 SW 104 St
Miami, FL 33156 - Phone
- (305) 279-7546
- Fax
- (305) 279-4180
- NPI assigned
- Jul 27, 2007
- Last updated
- Jul 25, 2016
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical & Laboratory Dermatological Immunology Physician | 207NI0002X | PA 9104126 | FL | Primary |
Addresses
Primary practice location
7700 SW 104 St
Miami, FL 33156
Mailing address
7700 SW 104 St
Miami, FL 33156
Phone (305) 279-7546
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| PA 9104126 | Other | FL | LICENSE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PA 9104126 | FL | MD | Clinical & Laboratory Dermatological Immunology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1185494400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1469404800000",
"number": "1184814071",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7700 SW 104 ST",
"city": "MIAMI",
"state": "FL",
"postal_code": "33156",
"telephone_number": "305-279-7546",
"fax_number": "305-279-4180"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7700 SW 104 ST",
"city": "MIAMI",
"state": "FL",
"postal_code": "33156",
"telephone_number": "305-279-7546",
"fax_number": "305-279-4180"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARTINEZ",
"first_name": "JENNIFER",
"middle_name": "A",
"name_prefix": "Mrs.",
"credential": "PA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-07-27",
"last_updated": "2016-07-25",
"status": "A"
},
"taxonomies": [
{
"code": "207NI0002X",
"taxonomy_group": "",
"desc": "Dermatology, Clinical & Laboratory Dermatological Immunology",
"state": "FL",
"license": "PA 9104126",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LICENSE",
"identifier": "PA 9104126",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Miami, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.