Basic Information
| Provider Information | |||||||||
| NPI: | 1346685245 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | PEDRO MARTINEZ-CLARK MD PA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 5040 NW 7TH STREET | ||||||||
| Address2: | SUITE 750 | ||||||||
| City: | MIAMI | ||||||||
| State: | FL | ||||||||
| PostalCode: | 331263490 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3055871752 | ||||||||
| FaxNumber: | 7865049432 | ||||||||
| Practice Location | |||||||||
| Address1: | 5040 NW 7TH STREET | ||||||||
| Address2: | SUITE 750 | ||||||||
| City: | MIAMI | ||||||||
| State: | FL | ||||||||
| PostalCode: | 331263490 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3055871752 | ||||||||
| FaxNumber: | 3053972986 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/06/2013 | ||||||||
| LastUpdateDate: | 11/22/2015 | ||||||||
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| AuthorizedOfficialLastName: | MARTINEZ-CLARK | ||||||||
| AuthorizedOfficialFirstName: | PEDRO | ||||||||
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| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 3055871752 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RI0011X | ME97003 | FL | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine | Interventional Cardiology |
No ID Information.