Healthcare Provider Details

I. General information

NPI: 1588572838
Provider Name (Legal Business Name): MARCELA MARTINEZ
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/28/2026
Last Update Date: 08/28/2026
Certification Date: 08/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20805 W 151ST ST STE 400
OLATHE KS
66061-7249
US

IV. Provider business mailing address

4418 CAMBRIDGE ST
KANSAS CITY KS
66103-3506
US

V. Phone/Fax

Practice location:
  • Phone: 913-445-4900
  • Fax:
Mailing address:
  • Phone: 913-948-1334
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number53-85060-022
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: