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General NPI Number Information
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NPI Number | 1730553702
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Entity Type | Individual
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Provider Name | AMBER JILL MARTINEZ M.S., CCC-SLP
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Gender | Female
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Dates
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Enumeration Date | 11/13/2015
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Last Update Date | 11/06/2025
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Provider Practice Location Address
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Address Line | 250 LAND GRANT ST STE 250-1
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City | ST AUGUSTINE
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State | FL
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Zip | 32092-1681
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Country | US
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Telephone | 904-886-3228
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Fax |
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Provider Business Mailing Address
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Address Line | 6505 SHILOH RD STE 100
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City | ALPHARETTA
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State | GA
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Zip | 30005-1645
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Country | US
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Telephone | 678-648-7644
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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 | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | SA 15135
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | SLP009559
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License Number State | GA
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