Provider Demographics
NPI:1336860857
Name:REYES MARTI, LARITZA J (FNP)
Entity Type:Individual
Prefix:
First Name:LARITZA
Middle Name:J
Last Name:REYES MARTI
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5000 23RD CT SW
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34116-6912
Mailing Address - Country:US
Mailing Address - Phone:239-961-7543
Mailing Address - Fax:
Practice Address - Street 1:5000 23RD CT SW
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34116-6912
Practice Address - Country:US
Practice Address - Phone:239-961-7543
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-09-05
Last Update Date:2022-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLF07220141363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily