Individual provider Active NPI

Lourdes Ines Martinez, M.S., R.D./L.D.

  • Registered Dietitian
  • Miami, FL
National Provider Identifier
1366717365
Registry record updated Mar 9, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
ND1885 Issued in FL
Practice address
2140 SW 21St Ter
Miami, FL 33145-2616
Phone
(786) 417-4099
NPI assigned
Mar 9, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 9, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X ND1885 FL Primary

Addresses

Primary practice location

2140 SW 21St Ter
Miami, FL 33145-2616

Mailing address

2140 SW 21St Ter
Miami, FL 33145-2616
Phone (786) 417-4099

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050413001039 FL Practitioner - Registered Dietitian Or Nutrition Professional 4880631522 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Registered Dietitian Or Nutrition Professional
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Citrus Health Network, Inc.Group PAC ID 9931177334, 49 clinicians

Practice addresses (Care Compare)

4125 W 20TH Ave
Hialeah, FL 33012-5874
Phone (305) 424-3120

4175 W 20TH Ave
Hialeah, FL 33012-5874
Phone (305) 825-0300

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
ND1885FLMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
Citrus Health Network Inc Current Accepting new patients
Citrus Health Network, Inc CurrentSince Mar 18, 2024 Accepting new patients
Citrus Health Network, Inc. CurrentSince Mar 18, 2024 Accepting new patients

Locations

4175 W 20th Ave
Hialeah, FL 33012
Phone (305) 424-3030

Organizations & group practices 3

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": "1331251200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1331251200000",
    "number": "1366717365",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2140 SW 21ST TER",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331452616",
            "telephone_number": "786-417-4099"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2140 SW 21ST TER",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331452616",
            "telephone_number": "786-417-4099"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTINEZ",
        "first_name": "LOURDES",
        "middle_name": "INES",
        "name_prefix": "Mrs.",
        "credential": "M.S., R.D./L.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-03-09",
        "last_updated": "2012-03-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "FL",
            "license": "ND1885",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Mar 9, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.