Provider Demographics
NPI:1609646546
Name:MARTINEZ, DARLY (FAMILY NURSE PRACTIT)
Entity type:Individual
Prefix:
First Name:DARLY
Middle Name:
Last Name:MARTINEZ
Suffix:
Gender:F
Credentials:FAMILY NURSE PRACTIT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24426 SW 108TH PL
Mailing Address - Street 2:
Mailing Address - City:HOMESTEAD
Mailing Address - State:FL
Mailing Address - Zip Code:33032-4668
Mailing Address - Country:US
Mailing Address - Phone:786-271-3213
Mailing Address - Fax:
Practice Address - Street 1:24426 SW 108TH PL
Practice Address - Street 2:
Practice Address - City:HOMESTEAD
Practice Address - State:FL
Practice Address - Zip Code:33032-4668
Practice Address - Country:US
Practice Address - Phone:786-271-3213
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-02
Last Update Date:2024-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLF11230524207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine