Individual provider Active NPI

Angelisse Marie Martinez, NP

  • Primary Care Nurse Practitioner
  • Kissimmee, FL
National Provider Identifier
1013417070
Registry record updated Oct 4, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
License
APRN11006283 Issued in FL
Practice address
3230 Hillsdale LN
Kissimmee, FL 34741-7562
Phone
(407) 785-1967
NPI assigned
Feb 16, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 4, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Nurse Practitioner 363LP2300X APRN11006283 FL Primary

Addresses

Primary practice location

3230 Hillsdale LN
Kissimmee, FL 34741-7562

Mailing address

3230 Hillsdale LN
Kissimmee, FL 34741-7562
Phone (787) 568-1506

Other names 1

  • Angelisse Marie Aviles Torres Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200922000828 FL Practitioner - Nurse Practitioner 9133543044 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Florida Pain Relief Group PLLCGroup PAC ID 4688960271, 80 clinicians

Practice addresses (Care Compare)

11251 S Orange Blossom TRL
Suite 101
Orlando, FL 32837-9297
Phone (407) 785-1967

3450 E Fletcher Ave
Suite 350
Tampa, FL 33613-4699
Phone (813) 739-7493

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
APRN11006283FLMDPrimary Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Pain Relief Group PLLC CurrentSince Nov 1, 2023 Accepting new patients

Locations

3230 Hillsdale Ln
Kissimmee, FL 34741
Phone (407) 413-3200

11251 S Orange Blossom Trl
Ste 101
Orlando, FL 32837
Phone (407) 501-6841

3450 E Fletcher Ave
Ste 350
Tampa, FL 33613
Phone (813) 739-7493

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1518739200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696377600000",
    "number": "1013417070",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3230 HILLSDALE LN",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347417562",
            "telephone_number": "787-568-1506"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3230 HILLSDALE LN",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347417562",
            "telephone_number": "407-785-1967"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTINEZ",
        "first_name": "ANGELISSE",
        "middle_name": "MARIE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-02-16",
        "last_updated": "2023-10-04",
        "certification_date": "2023-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "FL",
            "license": "APRN11006283",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANGELISSE",
            "last_name": "AVILES TORRES",
            "middle_name": "MARIE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Kissimmee, FL

Sources for this page

Verify at the official NPI Registry.