Provider Demographics
NPI:1174755276
Name:MARTINEZ, PLACIDA (MD)
Entity type:Individual
Prefix:DR
First Name:PLACIDA
Middle Name:
Last Name:MARTINEZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:247 CLEMSON ST
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89074-5484
Mailing Address - Country:US
Mailing Address - Phone:480-370-4744
Mailing Address - Fax:
Practice Address - Street 1:247 CLEMSON ST
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89074-5484
Practice Address - Country:US
Practice Address - Phone:480-370-4744
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-08-22
Last Update Date:2021-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ41590208000000X
DCMD038271208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics