Provider Demographics
NPI:1205098969
Name:MARTENS, AURELIA DEL MUNDO (LMT)
Entity type:Individual
Prefix:
First Name:AURELIA
Middle Name:DEL MUNDO
Last Name:MARTENS
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10008 GIFFORD DR
Mailing Address - Street 2:
Mailing Address - City:SPRING HILL
Mailing Address - State:FL
Mailing Address - Zip Code:34608-2721
Mailing Address - Country:US
Mailing Address - Phone:352-686-7789
Mailing Address - Fax:352-686-7789
Practice Address - Street 1:10008 GIFFORD DR
Practice Address - Street 2:
Practice Address - City:SPRING HILL
Practice Address - State:FL
Practice Address - Zip Code:34608-2721
Practice Address - Country:US
Practice Address - Phone:352-686-7789
Practice Address - Fax:352-686-7789
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-25
Last Update Date:2008-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMA38046225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist