Provider Demographics
NPI:1245660927
Name:GIAMBRONE, MARTA ELAINA
Entity type:Individual
Prefix:MS
First Name:MARTA
Middle Name:ELAINA
Last Name:GIAMBRONE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 561
Mailing Address - Street 2:
Mailing Address - City:INDIANTOWN
Mailing Address - State:FL
Mailing Address - Zip Code:34956-0561
Mailing Address - Country:US
Mailing Address - Phone:772-209-8560
Mailing Address - Fax:
Practice Address - Street 1:16274 SW FOUR WOOD WAY
Practice Address - Street 2:
Practice Address - City:INDIANTOWN
Practice Address - State:FL
Practice Address - Zip Code:34956-3606
Practice Address - Country:US
Practice Address - Phone:772-209-8560
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-11-18
Last Update Date:2013-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator