MEDICARE: MRS. ALFREDA MARTEZ ERVAN CNA

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	376K00000X	Nurse's Aide	136675	FL

General Provider Information

NPI Number	:	1629866579
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. ALFREDA MARTEZ ERVAN CNA

Provider Business Mailing Address
First Line	:	2448 ROXBURY CIR
Second Line	:
City	:	NORTH PORT
State	:	FL
Zip	:	34287-1755
Country	:	US
Telephone Number	:	941-979-2557
Fax Number	:

Provider Business Practice Location Address
First Line	:	2448 ROXBURY CIR
Second Line	:
City	:	NORTH PORT
State	:	FL
Zip	:	34287-1755
Country	:	US
Telephone Number	:	941-979-2557
Fax Number	:

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

Provider Enumeration Date	:	04/29/2025
Last Update Date	:	04/29/2025

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