Provider Demographics
NPI:1417085044
Name:NALDA, MARTIERY (DC)
Entity Type:Individual
Prefix:DR
First Name:MARTIERY
Middle Name:
Last Name:NALDA
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:MARTIERY
Other - Middle Name:
Other - Last Name:PEREZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 700116
Mailing Address - Street 2:
Mailing Address - City:SAINT CLOUD
Mailing Address - State:FL
Mailing Address - Zip Code:34770-0116
Mailing Address - Country:US
Mailing Address - Phone:407-957-1337
Mailing Address - Fax:407-957-1848
Practice Address - Street 1:4041 13TH ST
Practice Address - Street 2:
Practice Address - City:SAINT CLOUD
Practice Address - State:FL
Practice Address - Zip Code:34769-6772
Practice Address - Country:US
Practice Address - Phone:407-957-1337
Practice Address - Fax:407-957-1848
Is Sole Proprietor?:No
Enumeration Date:2007-03-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH 7446111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL55657OtherBCBS
FL55657Medicare ID - Type Unspecified