Provider Demographics
NPI:1902371933
Name:MARTINEZ, LETICIA JACQUELINE (ARNP-FNP-C)
Entity Type:Individual
Prefix:
First Name:LETICIA
Middle Name:JACQUELINE
Last Name:MARTINEZ
Suffix:
Gender:F
Credentials:ARNP-FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 441087
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33144-1087
Mailing Address - Country:US
Mailing Address - Phone:305-221-0200
Mailing Address - Fax:305-677-2711
Practice Address - Street 1:7171 CORAL WAY STE 311
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33155-1692
Practice Address - Country:US
Practice Address - Phone:305-221-0200
Practice Address - Fax:305-677-2711
Is Sole Proprietor?:No
Enumeration Date:2018-10-05
Last Update Date:2018-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9355146363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily