Individual provider Active NPI

Roberto Martinez Palacios, PHARMD

  • Pharmacist
  • Cape Coral, FL
National Provider Identifier
1366020604
Registry record updated Mar 30, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
PS62039 Issued in FL
Practice address
1611 NE Pine Island Rd
Cape Coral, FL 33909-1797
Phone
(239) 242-1050
NPI assigned
Mar 30, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 30, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X PS62039 FL Primary

Addresses

Primary practice location

1611 NE Pine Island Rd
Cape Coral, FL 33909-1797

Mailing address

6862 W 2ND CT
Hialeah, FL 33014-5302

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
PS62039FLMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Holiday CVS L.L.C. PastSince Apr 6, 2021 Accepting new patients
Holiday CVS LLC PastSince Apr 6, 2021 Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1617062400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617062400000",
    "number": "1366020604",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6862 W 2ND CT",
            "city": "HIALEAH",
            "state": "FL",
            "postal_code": "330145302"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1611 NE PINE ISLAND RD",
            "city": "CAPE CORAL",
            "state": "FL",
            "postal_code": "339091797",
            "telephone_number": "239-242-1050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTINEZ PALACIOS",
        "first_name": "ROBERTO",
        "name_prefix": "Dr.",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-03-30",
        "last_updated": "2021-03-30",
        "certification_date": "2021-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "FL",
            "license": "PS62039",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cape Coral, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.