Provider Demographics
NPI:1861630881
Name:MARTIELLI, JEAN J (AP)
Entity Type:Individual
Prefix:
First Name:JEAN
Middle Name:J
Last Name:MARTIELLI
Suffix:
Gender:F
Credentials:AP
Other - Prefix:
Other - First Name:QUINN
Other - Middle Name:J
Other - Last Name:MARTIELLI
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:927 4TH ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33139-6825
Mailing Address - Country:US
Mailing Address - Phone:305-534-0435
Mailing Address - Fax:
Practice Address - Street 1:927 4TH ST
Practice Address - Street 2:
Practice Address - City:MIAMI BEACH
Practice Address - State:FL
Practice Address - Zip Code:33139-6825
Practice Address - Country:US
Practice Address - Phone:305-534-0435
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-29
Last Update Date:2024-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL0000445171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist