Provider Demographics
NPI:1184221723
Name:MARTINEZ, LESTER (APRN)
Entity Type:Individual
Prefix:DR
First Name:LESTER
Middle Name:
Last Name:MARTINEZ
Suffix:
Gender:M
Credentials:APRN
Other - Prefix:DR
Other - First Name:LESTER
Other - Middle Name:
Other - Last Name:MARTINEZ
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:APRN
Mailing Address - Street 1:PO BOX 198136
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30384-0900
Mailing Address - Country:US
Mailing Address - Phone:786-595-8700
Mailing Address - Fax:
Practice Address - Street 1:14420 COMMERCE WAY
Practice Address - Street 2:
Practice Address - City:MIAMI LAKES
Practice Address - State:FL
Practice Address - Zip Code:33016-1508
Practice Address - Country:US
Practice Address - Phone:786-595-8700
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-06
Last Update Date:2023-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11009514363LF0000X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily