Individual
KEVIN JESUS MARTINEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
NAVY MEDICINE SUPPORT COMMAND ATTN: MEDICAL STAFF SVCS, BLDG H 2005 KNIGHT LANE, JACKSONVILLE, FL 32212-0140
(760) 725-3213
Mailing address
365 POMELO DR APT F20, VISTA, CA 92081-6373
(623) 498-9984
Taxonomy
Speciality
Code
Description
License number
State
126800000X
Dental Assistant
Primary
—
—
Other
Enumeration date
12/06/2019
Last updated
12/06/2019
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