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Individual

MS. MARTA C CARMONA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LMHC

Contact information

Practice address
12550 NEW BRITTANY BLVD STE 100, FORT MYERS, FL 33907-3655
(239) 343-9180
(239) 343-9188
Mailing address
PO BOX 2147, FORT MYERS, FL 33902-2147
(239) 343-9180
(239) 343-9188

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
MH5439
FL
103T00000X
Psychologist
Primary
PY9001
FL
103TC0700X
Clinical Psychologist
PY9001
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
12577600
FL
Enumeration date
05/01/2007
Last updated
04/24/2025
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