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Individual

MRS. KRISTI MICHAELA MARTINEZ

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
2906 17TH ST, SAINT CLOUD, FL 34769-6006
(321) 841-7856
(321) 843-6432
Mailing address
2906 17TH ST, SAINT CLOUD, FL 34769-6006
(321) 841-7856
(321) 843-6432

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
PA9116658
FL
363AM0700X
Medical Physician Assistant
Primary
PA9116658
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
124078800
FL
Enumeration date
10/13/2022
Last updated
10/04/2024
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