Healthcare Provider Details

I. General information

NPI: 1316563786
Provider Name (Legal Business Name): AQUILES SALVADOR MARTINEZ HERNANDEZ FNP-C
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/22/2020
Last Update Date: 09/25/2025
Certification Date: 09/25/2025
Deactivation Date: 03/12/2024
Reactivation Date: 03/20/2024

III. Provider practice location address

3450 11TH CT STE 302
VERO BEACH FL
32960-5012
US

IV. Provider business mailing address

3450 11TH CT STE 302
VERO BEACH FL
32960-5012
US

V. Phone/Fax

Practice location:
  • Phone: 540-514-6069
  • Fax:
Mailing address:
  • Phone: 540-514-6069
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number11031795
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code246ZC0007X
TaxonomySurgical Assistant
License Number20-271
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: