Provider Demographics
NPI:1013456664
Name:MARTINEZ JIMENEZ, JOHN FRANCISCO (SA-C, RSA)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:FRANCISCO
Last Name:MARTINEZ JIMENEZ
Suffix:
Gender:M
Credentials:SA-C, RSA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:935 KOKOMO KEY LN
Mailing Address - Street 2:
Mailing Address - City:DELRAY BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33483-6031
Mailing Address - Country:US
Mailing Address - Phone:312-315-8840
Mailing Address - Fax:
Practice Address - Street 1:935 KOKOMO KEY LN
Practice Address - Street 2:
Practice Address - City:DELRAY BEACH
Practice Address - State:FL
Practice Address - Zip Code:33483-6031
Practice Address - Country:US
Practice Address - Phone:312-315-8840
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-02-15
Last Update Date:2021-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL246ZC0007X
363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
No246ZC0007XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Assistant