MEDICARE: MRS. JUANITA MARIE MARTINEZ 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
1	363LF0000X	Family Nurse Practitioner	ARNP9419100	FL
2	363LF0000X	Family Nurse Practitioner	695949	TX

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
5	P01041264	OTHER	TX	MEDICARE RAILROAD

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1093003105
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. JUANITA MARIE MARTINEZ FNP

Provider Business Mailing Address
First Line	:	PO BOX 2147
Second Line	:
City	:	FORT MYERS
State	:	FL
Zip	:	33902-2147
Country	:	US
Telephone Number	:	239-424-1449
Fax Number	:	239-424-1423

Provider Business Practice Location Address
First Line	:	3501 HEALTH CENTER BLVD STE 2310
Second Line	:
City	:	ESTERO
State	:	FL
Zip	:	34135-8130
Country	:	US
Telephone Number	:	239-495-5020
Fax Number	:	239-495-5015

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

Provider Enumeration Date	:	07/11/2011
Last Update Date	:	07/21/2022

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Directions to “ MRS. JUANITA MARIE MARTINEZ FNP” Practice Location

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