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General NPI Number Information
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NPI Number | 1194600155
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Entity Type | Individual
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Provider Name | MARALYSA NATALIE MARTINEZ LDO
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Gender | Female
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Dates
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Enumeration Date | 08/08/2025
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Last Update Date | 08/08/2025
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Provider Practice Location Address
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Address Line | 3101 W PRINCETON ST
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City | ORLANDO
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State | FL
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Zip | 32808-5600
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Country | US
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Telephone | 321-354-2098
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Fax | 407-445-3032
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Provider Business Mailing Address
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Address Line | 3101 W PRINCETON ST
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City | ORLANDO
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State | FL
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Zip | 32808-5600
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Country | US
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Telephone |
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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 | 156FX1800X
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Taxonomy Name | Optician
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License Number | 6609
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License Number State | FL
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