Healthcare Provider Details

I. General information

NPI: 1538846159
Provider Name (Legal Business Name): CYNTHIA MARTINEZ FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: CINDY MARTINEZ

II. Dates (important events)

Enumeration Date: 07/05/2023
Last Update Date: 03/21/2025
Certification Date: 03/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2902 W AGUA FRIA FWY STE 1000
PHOENIX AZ
85027-3969
US

IV. Provider business mailing address

10200 GRAND CENTRAL AVE STE 220
OWINGS MILLS MD
21117-4366
US

V. Phone/Fax

Practice location:
  • Phone: 623-582-6420
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WP2201X
TaxonomyAmbulatory Care Registered Nurse
License Number150394
License Number StateAZ
# 2
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number303790
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: