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General NPI Number Information
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NPI Number | 1760464838
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Entity Type | Individual
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Provider Name | EMILIO MARTINEZ-LEZAMA OD
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Gender | Male
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Dates
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Enumeration Date | 11/15/2005
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Last Update Date | 03/22/2023
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Provider Practice Location Address
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Address Line | 2324 PINE RIDGE RD
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City | NAPLES
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State | FL
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Zip | 34109-2003
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Country | US
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Telephone | 239-330-3473
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Fax |
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Provider Business Mailing Address
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Address Line | 4652 SIESTA CIR
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City | FORT MYERS
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State | FL
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Zip | 33901-8830
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Country | US
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Telephone | 901-289-1877
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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 | 152W00000X
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Taxonomy Name | Optometrist
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License Number | OPC4214
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License Number State | FL
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