Basic Information
Provider Information
NPI: 1467697375
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: MARTINEZ
FirstName: LEONARDO
MiddleName: A.
NamePrefix:  
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName: MARTINEZ ROWE
OtherFirstName: LEONARDO
OtherMiddleName: ADRIAN
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential: M.D.
OtherLastNameType: 1
Mailing Information
Address1: 101 MANNING DR
Address2: CB 7010 DEPT OF ANESTHESIOLOGY
City: CHAPEL HILL
State: NC
PostalCode: 275997010
CountryCode: US
TelephoneNumber: 9199665136
FaxNumber: 9849744873
Practice Location
Address1: 101 MANNING DR
Address2: CB 7010 DEPT OF ANESTHESIOLOGY
City: CHAPEL HILL
State: NC
PostalCode: 275997010
CountryCode: US
TelephoneNumber: 9199665136
FaxNumber: 9849744873
Other Information
ProviderEnumerationDate: 12/05/2008
LastUpdateDate: 04/20/2017
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207L00000X0101252132VAN Allopathic & Osteopathic PhysiciansAnesthesiology 
207LP3000X2016-01758NCY Allopathic & Osteopathic PhysiciansAnesthesiologyPediatric Anesthesiology

No ID Information.


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