MEDICARE: JOSELENE MARTINEZ-CORREA PSY.D.

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	103TC0700X	Clinical Psychologist	004667	PR
2	103T00000X	Psychologist	PY10834	FL

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

General Provider Information

NPI Number	:	1245577261
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOSELENE MARTINEZ-CORREA PSY.D.

Provider Business Mailing Address
First Line	:	1936 BRUCE B DOWNS BLVD # 325
Second Line	:
City	:	WESLEY CHAPEL
State	:	FL
Zip	:	33544-9262
Country	:	US
Telephone Number	:	973-289-3500
Fax Number	:

Provider Business Practice Location Address
First Line	:	442 W KENNEDY BLVD STE 280
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33606-1464
Country	:	US
Telephone Number	:	813-467-6111
Fax Number	:

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

Provider Enumeration Date	:	01/10/2013
Last Update Date	:	06/01/2022

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