Healthcare Provider Details

I. General information

NPI: 1861339368
Provider Name (Legal Business Name): JAYMIE MARTINEZ
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/01/2026
Last Update Date: 05/01/2026
Certification Date: 05/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1720 MANATEE AVE E
BRADENTON FL
34208-1452
US

IV. Provider business mailing address

950 RIVER WIND CIR
BRADENTON FL
34212-3401
US

V. Phone/Fax

Practice location:
  • Phone: 941-299-3840
  • Fax:
Mailing address:
  • Phone: 303-591-1970
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License NumberFB9781168
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: