Healthcare Provider Details

I. General information

NPI: 1548223647
Provider Name (Legal Business Name): MARTIN LENOCI DPM
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/10/2006
Last Update Date: 03/07/2025
Certification Date: 03/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

240 N WICKHAM RD
MELBOURNE FL
32935-8662
US

IV. Provider business mailing address

2222 S HARBOR CITY BLVD
MELBOURNE FL
32901-5594
US

V. Phone/Fax

Practice location:
  • Phone: 321-308-5050
  • Fax: 321-984-9497
Mailing address:
  • Phone: 321-541-1715
  • Fax: 321-725-8739

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207XX0004X
TaxonomyOrthopaedic Foot and Ankle Surgery Physician
License NumberPO01949
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License NumberPO1949
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: