Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111N00000X | Chiropractor | X012179-1 | NY |
N | 111NI0013X | Independent Medical Examiner | X012179-1 | NY |
NPI | 1225358203 |
---|---|
Provider Name | Dr. Mariella Martinez-Navarro |
First Address | St Augustine, FL 32084-2600 |
Second Address | Auburn, NY 13021-1311 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/06/2010 |
Last Update Date | 14/08/2012 |