Provider Demographics
NPI:1689151607
Name:ALVAREZ, MARTHA (FNP-BC)
Entity Type:Individual
Prefix:
First Name:MARTHA
Middle Name:
Last Name:ALVAREZ
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:MARTHA
Other - Middle Name:
Other - Last Name:ASENCIO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2682 SW 178TH ST
Mailing Address - Street 2:
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34473-4412
Mailing Address - Country:US
Mailing Address - Phone:856-297-3387
Mailing Address - Fax:
Practice Address - Street 1:10770 SE 173RD ST
Practice Address - Street 2:
Practice Address - City:SUMMERFIELD
Practice Address - State:FL
Practice Address - Zip Code:34491-6851
Practice Address - Country:US
Practice Address - Phone:352-425-7321
Practice Address - Fax:352-748-2700
Is Sole Proprietor?:No
Enumeration Date:2018-07-23
Last Update Date:2022-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ00831600207Q00000X
FL9490616207Q00000X
FLAPRN9490616363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine