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General NPI Number Information
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NPI Number | 1093003105
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Entity Type | Individual
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Provider Name | JUANITA MARIE MARTINEZ FNP
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Gender | Female
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Dates
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Enumeration Date | 07/11/2011
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 3501 HEALTH CENTER BLVD STE 2310
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City | ESTERO
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State | FL
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Zip | 34135-8130
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Country | US
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Telephone | 239-495-5020
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Fax | 239-495-5015
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Provider Business Mailing Address
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Address Line | PO BOX 2147
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City | FORT MYERS
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State | FL
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Zip | 33902-2147
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Country | US
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Telephone | 239-424-1449
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Fax | 239-424-1423
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | ARNP9419100
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 695949
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License Number State | TX
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