Healthcare Provider Details
I. General information
NPI: 1598358160
Provider Name (Legal Business Name): ROSY LUZ MARTINEZ FERNANDEZ
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 02/15/2021
Last Update Date: 12/12/2025
Certification Date: 12/12/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
9371 FONTAINEBLEAU BLVD APT I121
MIAMI FL
33172-5672
US
IV. Provider business mailing address
9371 FONTAINEBLEAU BLVD APT I121
MIAMI FL
33172-5672
US
V. Phone/Fax
- Phone: 786-278-1181
- Fax:
- Phone: 786-278-1181
- Fax: 727-606-4886
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 101YM0800X |
| Taxonomy | Mental Health Counselor |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 363LP0808X |
| Taxonomy | Psychiatric/Mental Health Nurse Practitioner |
| License Number | APRN11011558 |
| License Number State | FL |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 363LF0000X |
| Taxonomy | Family Nurse Practitioner |
| License Number | 11011558 |
| License Number State | FL |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: