Individual
IVAN MARTINEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RN
Contact information
Practice address
2108 N OLA AVE UNIT 718, TAMPA, FL 33602-2026
(813) 404-8922
Mailing address
2108 N OLA AVE UNIT 718, TAMPA, FL 33602-2026
(813) 404-8922
Taxonomy
Speciality
Code
Description
License number
State
163WE0003X
Emergency Registered Nurse
Primary
9381202
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
9381202
STATE NURSING LICENSE
FL
Enumeration date
06/06/2020
Last updated
06/06/2020
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