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General NPI Number Information
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NPI Number | 1245980465
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Entity Type | Organization
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Legal Business Name | INSIGHT PSYCHIATRY, LLC
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Dates
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Enumeration Date | 03/29/2022
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Last Update Date | 03/29/2022
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Provider Practice Location Address
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Address Line | 6811 PORTO FINO CIR
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City | FORT MYERS
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State | FL
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Zip | 33912-4354
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Country | US
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Telephone | 239-766-5693
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Fax |
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Provider Business Mailing Address
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Address Line | 1307 PAR VIEW DR
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City | SANIBEL
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State | FL
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Zip | 33957-6409
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Country | US
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Telephone | 207-217-0140
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Fax |
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Authorized Official
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Title or Position | PSYCHIATRIST
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Name | DR. JILL HUSSON MARTINEZ
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Credential | MD
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Telephone | 239-766-5693
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number |
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License Number State |
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