Provider Demographics
NPI:1568992089
Name:MARTINEZ-MALDONADO, JAMI NICOLE (ARNP)
Entity Type:Individual
Prefix:MRS
First Name:JAMI
Middle Name:NICOLE
Last Name:MARTINEZ-MALDONADO
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:JAMI
Other - Middle Name:NICOLE
Other - Last Name:MARTINEZ
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:ARNP
Mailing Address - Street 1:12920 EARLY RUN LN
Mailing Address - Street 2:
Mailing Address - City:RIVERVIEW
Mailing Address - State:FL
Mailing Address - Zip Code:33578-3383
Mailing Address - Country:US
Mailing Address - Phone:813-965-6062
Mailing Address - Fax:813-574-7145
Practice Address - Street 1:4874 SUN CITY CENTER BLVD
Practice Address - Street 2:
Practice Address - City:SUN CITY CENTER
Practice Address - State:FL
Practice Address - Zip Code:33573-6281
Practice Address - Country:US
Practice Address - Phone:813-633-2000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-06-18
Last Update Date:2017-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9356315363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily