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NPI Code Detail

MEDICARE: GIANNI MARTINEZ RIVERA

MEDICARE: GIANNI MARTINEZ RIVERA
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
1363LF0000XFamily Nurse Practitioner11018459FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1982351573
Entity Type Code : Individual
Provider Name (Legal Business Name) : GIANNI MARTINEZ RIVERA
Provider Business Mailing Address
First Line : 8210 RUSTIC DR
Second Line :
City : TAMPA
State : FL
Zip : 33634-2285
Country : US
Telephone Number : 786-910-4117
Fax Number :
Provider Business Practice Location Address
First Line : 11211 N NEBRASKA AVE
Second Line :
City : TAMPA
State : FL
Zip : 33612-5777
Country : US
Telephone Number : 813-443-0783
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/03/2022
Last Update Date : 03/03/2022

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Directions to “ GIANNI MARTINEZ RIVERA ” Practice Location

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