Provider Demographics
NPI:1306620760
Name:MARTINEZ DELGADO, NANCY
Entity type:Individual
Prefix:MRS
First Name:NANCY
Middle Name:
Last Name:MARTINEZ DELGADO
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 1:4826 TUDOR DR APT B
Mailing Address - Street 2:
Mailing Address - City:CAPE CORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33904-5890
Mailing Address - Country:US
Mailing Address - Phone:239-371-7913
Mailing Address - Fax:
Practice Address - Street 1:4826 TUDOR DR APT B
Practice Address - Street 2:
Practice Address - City:CAPE CORAL
Practice Address - State:FL
Practice Address - Zip Code:33904-5890
Practice Address - Country:US
Practice Address - Phone:239-371-7913
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-24
Last Update Date:2024-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-23-288776106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician