Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 390200000 | FL |
N | 111NI0900X | Internist | 390200000 | FL |
Y | 207RH0002X | Hospice and Palliative Medicine | ME146044 | FL |
NPI | 1144679739 |
---|---|
Provider Name | Leonalba Martinez |
First Address | Fort Myers, FL 33902-2147 |
Second Address | Fort Myers, FL 33905-7813 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/06/2016 |
Last Update Date | 29/03/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
107238300 | (05) | FL |