Provider Demographics
NPI:1033399324
Name:MARTINELLI, SANDRA JANE (LMT)
Entity Type:Individual
Prefix:MS
First Name:SANDRA
Middle Name:JANE
Last Name:MARTINELLI
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1201 S HIGHLAND AVE STE 1
Mailing Address - Street 2:
Mailing Address - City:CLEARWATER
Mailing Address - State:FL
Mailing Address - Zip Code:33756-4381
Mailing Address - Country:US
Mailing Address - Phone:727-481-1560
Mailing Address - Fax:
Practice Address - Street 1:1201 S HIGHLAND AVE STE 1
Practice Address - Street 2:
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33756-4381
Practice Address - Country:US
Practice Address - Phone:727-481-1560
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-05
Last Update Date:2007-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMA50516174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist