# MARIO P MARTINEZ

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1891904132
- **Gender:** Man
- **Credential:** NP

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363L00000X | Nurse Practitioner | NP-817A | ID | Yes |
| 363L00000X | Nurse Practitioner | NP817A | ID | — |

## Other

- **Enumeration date:** 05/22/2007
- **Last updated:** 07/07/2026

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 80705880 | — | ID |
| 05 | — | 807746300 | — | ID |