Provider Demographics
NPI:1760286983
Name:RIVERA MARTINEZ, JOSE ALFREDO (MD)
Entity type:Individual
Prefix:
First Name:JOSE
Middle Name:ALFREDO
Last Name:RIVERA MARTINEZ
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3714 NE LAKE SEBRING DR
Mailing Address - Street 2:
Mailing Address - City:SEBRING
Mailing Address - State:FL
Mailing Address - Zip Code:33870-8452
Mailing Address - Country:US
Mailing Address - Phone:787-406-4425
Mailing Address - Fax:
Practice Address - Street 1:141 N 6TH ST
Practice Address - Street 2:
Practice Address - City:HAINES CITY
Practice Address - State:FL
Practice Address - Zip Code:33844-4207
Practice Address - Country:US
Practice Address - Phone:863-353-1538
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-04
Last Update Date:2025-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11038650363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily