Healthcare Provider Details

I. General information

NPI: 1952060089
Provider Name (Legal Business Name): ISABELLA ANANAISE MARTINEZ
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/16/2021
Last Update Date: 09/02/2026
Certification Date: 09/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

351 W 33RD ST
HIALEAH FL
33012-4305
US

IV. Provider business mailing address

351 W 33RD ST
HIALEAH FL
33012-4305
US

V. Phone/Fax

Practice location:
  • Phone: 305-794-3518
  • Fax:
Mailing address:
  • Phone: 305-794-3518
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPS71361
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: