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NPI Code Detail

MEDICARE: MARTY JOHN FLORENDO MUSNI FNP

MEDICARE: MARTY JOHN FLORENDO MUSNI FNP
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
1363LF0000XFamily Nurse Practitioner0999001CO

General Provider Information

NPI Number : 1013795038
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARTY JOHN FLORENDO MUSNI FNP
Provider Business Mailing Address
First Line : 5635 VERMILLION BLUFFS DR
Second Line :
City : COLORADO SPRINGS
State : CO
Zip : 80923-3471
Country : US
Telephone Number : 850-826-1518
Fax Number :
Provider Business Practice Location Address
First Line : 1550 PULSAR DR
Second Line :
City : COLORADO SPRINGS
State : CO
Zip : 80916-4503
Country : US
Telephone Number : 719-632-4455
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/20/2023
Last Update Date : 09/20/2023

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