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NPI Code Detail

MEDICARE: JUDY ANN MARTIN

MEDICARE:   JUDY ANN MARTIN
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
13747A0650XAttendant Care Provider

General Provider Information

NPI Number : 1730961855
Entity Type Code : Individual
Provider Name (Legal Business Name) : JUDY ANN MARTIN
Provider Business Mailing Address
First Line : 1577 ACHILLES ST
Second Line :
City : PORT CHARLOTTE
State : FL
Zip : 33980-4848
Country : US
Telephone Number : 229-251-6255
Fax Number :
Provider Business Practice Location Address
First Line : 1577 ACHILLES ST
Second Line :
City : PORT CHARLOTTE
State : FL
Zip : 33980-4848
Country : US
Telephone Number : 122-925-1625
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/16/2023
Last Update Date : 10/20/2023

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Directions to “ JUDY ANN MARTIN ” Practice Location

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