Healthcare Provider Details

I. General information

NPI: 1609610781
Provider Name (Legal Business Name): BRIGITTE MARIE MARTINEZ APRN, FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/24/2024
Last Update Date: 08/10/2026
Certification Date: 08/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

26314 WESLEY CHAPEL BLVD
LUTZ FL
33559-7208
US

IV. Provider business mailing address

5216 HOPEDALE DR
TAMPA FL
33624-4847
US

V. Phone/Fax

Practice location:
  • Phone: 813-385-1651
  • Fax:
Mailing address:
  • Phone: 813-385-1651
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number11033762
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: