MEDICARE: MR. MATTHEW R MARTINI FNP-BC

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	363L00000X	Nurse Practitioner	843212	NV

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	843212	OTHER	NV	STATE LICENSE

General Provider Information

NPI Number	:	1760154264
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. MATTHEW R MARTINI FNP-BC

Provider Business Mailing Address
First Line	:	6101 BLUE LAGOON DR STE 200
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33126-3168
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3265 E TROPICANA AVE STE B
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89121-7386
Country	:	US
Telephone Number	:	702-840-2583
Fax Number	:	855-592-2967

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

Provider Enumeration Date	:	10/02/2021
Last Update Date	:	02/19/2026

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