MEDICARE: CARMEN DELIA MARTINEZ

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	225100000X	Physical Therapist	4145	FL

General Provider Information

NPI Number	:	1528824190
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CARMEN DELIA MARTINEZ

Provider Business Mailing Address
First Line	:	10334 GOLDENBROOK WAY
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33647-2929
Country	:	US
Telephone Number	:	813-417-7215
Fax Number	:

Provider Business Practice Location Address
First Line	:	10334 GOLDENBROOK WAY
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33647-2929
Country	:	US
Telephone Number	:	813-417-7215
Fax Number	:

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

Provider Enumeration Date	:	02/22/2024
Last Update Date	:	02/22/2024

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Directions to “ CARMEN DELIA MARTINEZ ” Practice Location

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