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General NPI Number Information
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NPI Number | 1194508119
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Entity Type | Individual
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Provider Name | JENNIFER MARTINEZ
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Gender | Female
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Dates
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Enumeration Date | 08/15/2023
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Last Update Date | 08/15/2023
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Provider Practice Location Address
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Address Line | 11190 HEALTH PARK BLVD
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City | NAPLES
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State | FL
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Zip | 34110-5729
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Country | US
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Telephone | 239-624-5000
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Fax |
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Provider Business Mailing Address
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Address Line | 28120 CREST PRESERVE CIR UNIT 3301
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City | BONITA SPRINGS
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State | FL
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Zip | 34135-6694
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Country | US
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Telephone | 786-709-7057
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Fax |
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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 | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 9538177
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License Number State | FL
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