Provider Demographics
NPI:1972217537
Name:MARTINEZ, ANNABELLE JAMIE (RN)
Entity type:Individual
Prefix:MRS
First Name:ANNABELLE
Middle Name:JAMIE
Last Name:MARTINEZ
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17163 NW COUNTY ROAD 12
Mailing Address - Street 2:
Mailing Address - City:BRISTOL
Mailing Address - State:FL
Mailing Address - Zip Code:32321-4085
Mailing Address - Country:US
Mailing Address - Phone:850-228-1031
Mailing Address - Fax:
Practice Address - Street 1:17163 NW COUNTY ROAD 12
Practice Address - Street 2:
Practice Address - City:BRISTOL
Practice Address - State:FL
Practice Address - Zip Code:32321-4085
Practice Address - Country:US
Practice Address - Phone:850-228-1031
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-01-09
Last Update Date:2023-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN9343266163WG0000X
FLAPRN11024262207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice