Provider Demographics
NPI:1548223647
Name:LENOCI, MARTIN (DPM)
Entity Type:Individual
Prefix:
First Name:MARTIN
Middle Name:
Last Name:LENOCI
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2222 S HARBOR CITY BLVD
Mailing Address - Street 2:
Mailing Address - City:MELBOURNE
Mailing Address - State:FL
Mailing Address - Zip Code:32901-5594
Mailing Address - Country:US
Mailing Address - Phone:321-541-1715
Mailing Address - Fax:321-725-8739
Practice Address - Street 1:2222 S HARBOR CITY BLVD
Practice Address - Street 2:SUITE 450
Practice Address - City:MELBOURNE
Practice Address - State:FL
Practice Address - Zip Code:32901-5594
Practice Address - Country:US
Practice Address - Phone:321-541-1715
Practice Address - Fax:321-725-8739
Is Sole Proprietor?:No
Enumeration Date:2006-04-10
Last Update Date:2014-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPO01949207XX0004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XX0004XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryFoot and Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
0884270001OtherDME SUPPLIER NUMBER
480013392OtherRAIL ROAD MEDICARE
FL340063800Medicaid
0884270001OtherDME SUPPLIER NUMBER
T87854Medicare UPIN