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General NPI Number Information
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NPI Number | 1285759555
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Entity Type | Individual
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Provider Name | JAMIE MARIE MARTIN OTR
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Gender | Female
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Dates
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Enumeration Date | 03/19/2007
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Last Update Date | 03/09/2011
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Provider Practice Location Address
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Address Line | 1533 4TH AVE W
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City | BRADENTON
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State | FL
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Zip | 34205-5949
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Country | US
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Telephone | 941-747-1881
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Fax |
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Provider Business Mailing Address
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Address Line | 9119 WINTER HARBOUR WAY
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City | BRADENTON
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State | FL
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Zip | 34212-6335
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Country | US
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Telephone | 941-373-1271
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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 | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 9811
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License Number State | FL
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