Healthcare Provider Details

I. General information

NPI: 1619690948
Provider Name (Legal Business Name): GERALDINE BELEN MARTINEZ RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/21/2022
Last Update Date: 05/06/2025
Certification Date: 05/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

601 E ROLLINS ST
ORLANDO FL
32803-1248
US

IV. Provider business mailing address

436 NEWTON PL
LONGWOOD FL
32779-2230
US

V. Phone/Fax

Practice location:
  • Phone: 407-303-2528
  • Fax: 407-303-2760
Mailing address:
  • Phone: 407-314-2718
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LN0000X
TaxonomyNeonatal Nurse Practitioner
License NumberAPRN11035985
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code163WN0002X
TaxonomyNeonatal Intensive Care Registered Nurse
License Number9385370
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: