MEDICARE: NIURKA M MARTINEZ MS, RDN, LDN

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	133V00000X	Registered Dietitian	9793	NY
2	133V00000X	Registered Dietitian	ND11341	FL

General Provider Information

NPI Number	:	1972365104
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NIURKA M MARTINEZ MS, RDN, LDN

Provider Business Mailing Address
First Line	:	719 RODEL CV STE 2001
Second Line	:
City	:	LAKE MARY
State	:	FL
Zip	:	32746-5716
Country	:	US
Telephone Number	:	407-302-3115
Fax Number	:	321-203-4602

Provider Business Practice Location Address
First Line	:	719 RODEL CV STE 2001
Second Line	:
City	:	LAKE MARY
State	:	FL
Zip	:	32746-5716
Country	:	US
Telephone Number	:	407-302-3115
Fax Number	:	321-203-4602

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

Provider Enumeration Date	:	01/24/2024
Last Update Date	:	01/29/2026

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