Healthcare Provider Details

I. General information

NPI: 1477141216
Provider Name (Legal Business Name): ROBERTO JOSE MARTINEZ ESPINOSA
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/07/2021
Last Update Date: 10/17/2025
Certification Date: 10/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

311 COMMERCE CENTER DR
SAINT CLOUD FL
34769-1549
US

IV. Provider business mailing address

1690 MADDUX LN
KINDRED FL
34744-6839
US

V. Phone/Fax

Practice location:
  • Phone: 407-989-4040
  • Fax: 407-989-4040
Mailing address:
  • Phone: 863-242-7400
  • Fax: 407-989-4040

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: