Provider Demographics
NPI:1285971390
Name:MARTINEZ URIBE, ANGELICA M (PA-C)
Entity type:Individual
Prefix:
First Name:ANGELICA
Middle Name:M
Last Name:MARTINEZ URIBE
Suffix:
Gender:
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2421 MILLCREEK LN APT 102
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34119-7903
Mailing Address - Country:US
Mailing Address - Phone:239-961-2536
Mailing Address - Fax:
Practice Address - Street 1:8931 COLONIAL CENTER DR STE 400
Practice Address - Street 2:
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33905-7809
Practice Address - Country:US
Practice Address - Phone:239-334-6626
Practice Address - Fax:239-334-0404
Is Sole Proprietor?:No
Enumeration Date:2013-01-09
Last Update Date:2025-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPA9107029363AM0700X, 363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical