MEDICARE: DR. JUSTINE FLORES MARTINEZ PHARM.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	PS54375	FL
2	183500000X	Pharmacist	16824-40	WI

General Provider Information

NPI Number	:	1356884282
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JUSTINE FLORES MARTINEZ PHARM.D.

Provider Business Mailing Address
First Line	:	2304 SW ABALON CIR
Second Line	:
City	:	PORT SAINT LUCIE
State	:	FL
Zip	:	34953-5718
Country	:	US
Telephone Number	:	312-307-4558
Fax Number	:

Provider Business Practice Location Address
First Line	:	5473 NW SAINT JAMES DR
Second Line	:
City	:	PORT SAINT LUCIE
State	:	FL
Zip	:	34983-3444
Country	:	US
Telephone Number	:	772-878-1526
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/26/2016
Last Update Date	:	11/26/2016

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