Individual
LAURA ENID MARTINEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2131 RIBBON FALLS PKWY, ORLANDO, FL 32824
(407) 779-3596
(407) 850-0090
Mailing address
2131 RIBBON FALLS PKWY, ORLANDO, FL 32824-4305
(407) 779-3596
(407) 850-0090
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
M635525795910
FL
Other
Enumeration date
05/03/2019
Last updated
05/03/2019
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