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Individual

JAVIER MARTINEZ SR.

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
CRNA

Contact information

Practice address
7 INDEPENDENCE PT STE 300, GREENVILLE, SC 29615-4569
(864) 522-3700
(864) 522-3705
Mailing address
300 E MCBEE AVE FL 4, GREENVILLE, SC 29601-2842
(864) 522-8603

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
719120
CA
367500000X
Certified Registered Nurse Anesthetist
Primary
26120
SC
367500000X
Certified Registered Nurse Anesthetist
NA95000463
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
PENDING
SC
Enumeration date
01/13/2016
Last updated
08/11/2022
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