MEDICARE: MARTINEZ LOVING CARE AGENCY INC

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	251E00000X	Home Health Agency

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	:	1811563463
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MARTINEZ LOVING CARE AGENCY INC

Provider Business Mailing Address
First Line	:	8404 WILSKY BLVD STE 108
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33615-1515
Country	:	US
Telephone Number	:	813-446-2988
Fax Number	:

Provider Business Practice Location Address
First Line	:	8404 WILSKY BLVD STE 108
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33615-1515
Country	:	US
Telephone Number	:	813-446-2988
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	GRETTELL BARRETO
Credential	:
Telephone Number	:	813-446-2988

Provider Enumeration Date	:	06/02/2021
Last Update Date	:	06/02/2021

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