Healthcare Provider Details

I. General information

NPI: 1629915541
Provider Name (Legal Business Name): MARTHA REMY
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/29/2026
Last Update Date: 04/29/2026
Certification Date: 04/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

237 NABOB AVE
LEHIGH ACRES FL
33974-0514
US

IV. Provider business mailing address

25241 ELEMENTARY WAY STE 200
BONITA SPRINGS FL
34135-7883
US

V. Phone/Fax

Practice location:
  • Phone: 914-525-3282
  • Fax:
Mailing address:
  • Phone: 914-525-3282
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code172M00000X
TaxonomyMechanotherapist
License NumberMA66954
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: