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General NPI Number Information
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NPI Number | 1396186961
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Entity Type | Individual
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Provider Name | LOURDES MARTINEZ BRENES MD
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Gender | Female
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Dates
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Enumeration Date | 07/11/2013
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Last Update Date | 10/03/2024
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Provider Practice Location Address
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Address Line | 109 TIMBERLACHEN CIR
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City | LAKE MARY
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State | FL
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Zip | 32746-3395
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Country | US
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Telephone | 407-333-9877
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Fax | 407-333-9881
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Provider Business Mailing Address
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Address Line | 5130 SUNFOREST DR STE 300
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City | TAMPA
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State | FL
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Zip | 33634-6327
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Country | US
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Telephone | 727-824-0780
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Fax | 813-514-8891
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 35.135338
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | ME127201
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License Number State | FL
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