MEDICARE: MS. MAYTE MARTINEZ APRN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LA2100X	Acute Care Nurse Practitioner	APRN11034188	FL

General Provider Information

NPI Number	:	1013710763
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. MAYTE MARTINEZ APRN

Provider Business Mailing Address
First Line	:	4430 SW 163RD PL
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33185-4578
Country	:	US
Telephone Number	:	305-582-4618
Fax Number	:

Provider Business Practice Location Address
First Line	:	4430 SW 163RD PL
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33185-4578
Country	:	US
Telephone Number	:	305-582-4618
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/28/2025
Last Update Date	:	04/09/2025

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