# MARTA JACENYIK LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1366589780
- **Authorized official:** DR. MARTA JACENYIK (PRESIDENT)
- **Authorized official phone:** (850) 934-9866

## Contact information

- **Practice address:** 3759 BENGAL RD, GULF BREEZE, FL 32563-3454
- **Practice address phone:** (850) 934-9866
- **Mailing address:** PO BOX 1171, GULF BREEZE, FL 32562-1171

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207QA0505X | Adult Medicine Physician | ME67496 | FL | Yes |

## Other

- **Enumeration date:** 02/01/2007
- **Last updated:** 03/03/2014