OCTAVIO VINCENT MARTINEZ (NPI# 1275987372) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1275987372 |
| Entity Type | Individual |
| Full Name | OCTAVIO VINCENT MARTINEZ |
| Credential | PHD |
| Practice Address |
1611 Nw 12th Ave Miami FL 33136-1005 |
| Practice Telephone | 3055857851 |
| Practice Fax Number | 3052431624 |
| Mailing Telephone | 3055857851 |
| Mailing Fax Number | 3052431624 |
| Enumeration Date | 2016-04-15 |
| Last Update Date | 2016-04-15 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 247ZC0005X |
Pathology Specialization: Clinical Laboratory Director, Non-physician |
DI14185 | FL | Technologists, Technicians & Other Technical Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376520080 | Octavio N. Martinez Jr. | Psychiatry & Neurology | 3001 Lake Austin Blvd, 4th Floor, Austin, TX 78703-4200 | 2005-12-23 |
| Street Address |
1611 NW 12TH AVE |
| City | MIAMI |
| State | FL |
| Zip Code | 33136-1005 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740286251 | Karen Chitty | Emergency Medicine | 1611 Nw 12th Ave, Miami, FL 33136-1005 | 2005-06-21 |
| 1558968263 | Natalie Dinger | Nurse Practitioner | 1611 Nw 12th Ave, Miami, FL 33136-1096 | 2020-10-06 |
| 1306452057 | Ryan M Bukhari | Dentist | 1611 Nw 12th Ave, Miami, FL 33136-1096 | 2020-09-18 |
| 1467068155 | Hussien Touny | Student in an Organized Health Care Education/Training Program | 1611 Nw 12th Ave, Miami, FL 33136-1096 | 2020-09-18 |
| 1912512310 | Clementina Aurora Cabrera | Student in an Organized Health Care Education/Training Program | 1611 Nw 12th Ave, Miami, FL 33136-1005 | 2020-09-11 |
| 1184237265 | Kencya Toussaint | Nurse Practitioner | 1611 Nw 12th Ave, Miami, FL 33136-1096 | 2020-08-28 |
| 1568075976 | Manuel Molina | Student in an Organized Health Care Education/Training Program | 1611 Nw 12th Ave, Miami, FL 33136-1005 | 2020-08-25 |
| 1063025468 | Carlos Federico Moral Ortega | Student in an Organized Health Care Education/Training Program | 1611 Nw 12th Ave, Miami, FL 33136-1096 | 2020-08-25 |
| 1770195919 | Ezekiel Oluwasayo Ijaopo | Student in an Organized Health Care Education/Training Program | 1611 Nw 12th Ave, Miami, FL 33136-1005 | 2020-08-19 |
| 1568070258 | Virosh Dharmadasa | Student in an Organized Health Care Education/Training Program | 1611 Nw 12th Ave, Miami, FL 33136-1005 | 2020-07-19 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548875685 | Agustina Dirocco | Registered Nurse | 1611 Ne 12th Ave, Miami, FL 33136 | 2020-09-15 |
| 1093338451 | Krizia Amy Vinck | Clinical Neuropsychologist | 1150 Nw 14th St, Miami, Fl 33136, Miami, FL 33136 | 2020-05-20 |
| 1992327761 | Jorge Luis Cardenas Alvarez | Student in an Organized Health Care Education/Training Program | 1611 Nw 12 Avenue Central Room 600-d, Miami, FL 33136 | 2020-05-14 |
| 1104447036 | Denver Steven Pinto | Student in an Organized Health Care Education/Training Program | 1611 Nw 12 Avenue Jackson Memorial Hospital, West Wing 279 Emergency Radiology, Miami, FL 33136 | 2020-05-01 |
| 1992325724 | Dimple Kumar Chanamolu | Student in an Organized Health Care Education/Training Program | Deptarment of Urology University of Miama Miller School, Crb 1120 Nw 14th Street Suite 1551c, Miami, FL 33136 | 2020-04-22 |
| 1578100996 | Alex Aziz Al Khoury | Internal Medicine | 1120 Nw 14th St. Suite 1112, Miami, FL 33136 | 2019-12-04 |
| 1437708872 | Marie Jeanjean | Genetic Counselor, MS | 1501 Nw 10th Avenue, Brb 334 (m860), Miami, FL 33136 | 2019-09-09 |
| 1710543905 | Tal Friehmann | Student in an Organized Health Care Education/Training Program | Jackson Memorial Hospital, Breast Imaging Dep, 1611 Nw 12 Avenue, Miami, FL 33136 | 2019-05-14 |
| 1285297895 | Omar Munoz | Student in an Organized Health Care Education/Training Program | 1611 Nw 12th Av., Psychiatry Department, Miami, FL 33136 | 2019-04-18 |
| 1902369648 | Seyedeh Haleh Amirian | Student in an Organized Health Care Education/Training Program | 1611 12th Avenue, Holtz Buiding, East Tower, 2169, Miami, FL 33136 | 2019-04-10 |
| Find all providers in zip 33136 | ||||
| Taxonomy Code | 247ZC0005X |
| Grouping | Technologists, Technicians & Other Technical Service Providers |
| Classification | Pathology |
| Specialization | Clinical Laboratory Director, Non-physician |
| An individual who is state-licensed as a clinical laboratory director and meets the qualifications in the Clinical Laboratory Improvement Amendments of 1988 for non-physicians (non-MD/DO) as defined in the CFR 42 Part 493.1405. |
| Notes: Source: National Uniform Claim Committee [1/1/2007: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780069724 | Charles Rego | Pathology | 10000 Sw 56th St, Suite 3, Miami, FL 33165-7165 | 2015-07-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922626795 | Sabrina Yvette Kelley | Pathology | 801 W Sr 436 Ste 2005, Altamonte Springs, FL 32714-3053 | 2020-07-08 |
| 1407315575 | Aitor Lartitegui | Pathology | 15481 Sw 12th St Ste 303, Sunrise, FL 33326-1993 | 2019-03-18 |
| 1912479130 | Jean S Sanon | Pathology | 3020 High Ridge Rd Ste 600, Boynton Beach, FL 33426-8731 | 2018-12-28 |
| 1538645122 | Brandie Underwood | Pathology | 255 Se 7th Ave Ste 3, Crystal River, FL 34429-4848 | 2018-07-17 |
| 1083117535 | Quality Clinical Lab LLC | Pathology | 2204 Us Highway 19, Holiday, FL 34691-4351 | 2018-03-12 |
| 1407373368 | Cheska Lee Burleson | Pathology | 921 39th Ave Ne, Saint Petersburg, FL 33703-5924 | 2017-08-23 |
| 1356867048 | Kendall Ather Bryant | Pathology | 520 Baker St, Orlando, FL 32806 | 2017-08-15 |
| 1215329552 | Joseph Coscia | Pathology | 28 Bermuda Lake Dr, Palm Beach Gardens, FL 33418-4584 | 2015-02-24 |
| 1942600465 | Judith Mcmorris | Pathology | 4537 Winding River Way, Land O Lakes, FL 34639-5734 | 2014-09-03 |
| 1972756955 | Rafael Rodriguez | Pathology | 8004 Nw 154th St # 197, Miami Lakes, FL 33016-5814 | 2008-11-04 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.