Provider Demographics
NPI:1306870977
Name:MARTINEZ, GLADYS R (DO)
Entity type:Individual
Prefix:DR
First Name:GLADYS
Middle Name:R
Last Name:MARTINEZ
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7086 BRUNSWICK CIR
Mailing Address - Street 2:
Mailing Address - City:BOYNTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33472-2533
Mailing Address - Country:US
Mailing Address - Phone:561-703-2047
Mailing Address - Fax:561-437-8120
Practice Address - Street 1:950 NW 9TH CT
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33486-2214
Practice Address - Country:US
Practice Address - Phone:561-819-6700
Practice Address - Fax:561-941-9409
Is Sole Proprietor?:No
Enumeration Date:2006-07-10
Last Update Date:2025-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS7477207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLF94431I413OtherVISTA
F94431I413OtherSUMMIT
56-2547040OtherHEALTH CARE DISTRICT
56-2547040OtherHUMANA
FL4573393OtherAETNA
FL55126OtherBLUE CROSS BLUE SHIELD
56-2547040OtherUNITED
4304693OtherCIGNA
FL305705OtherAVMED
FL650561267OtherTAX ID
FL305705OtherAVMED