Individual provider Active NPI

Edison Alexander Martinez, APRN

  • Family Nurse Practitioner
  • Melbourne, FL
National Provider Identifier
1073219820
Registry record updated Jul 7, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
11024253 Issued in FL
Practice address
6619 N Wickham Rd
Melbourne, FL 32940-2006
Phone
(407) 956-1920
NPI assigned
Feb 3, 2023
Last updated
Jul 7, 2026By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 7, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LF0000X 11024253 FL Primary

Addresses

Primary practice location

6619 N Wickham Rd
Melbourne, FL 32940-2006

Mailing address

6619 N Wickham Rd
Melbourne, FL 32940-2006
Phone (321) 259-9500

Other practice location 1

6156 Breslay Dr Ste 101
Viera, FL 32940-8727
Phone (321) 259-9500

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
I20230418000021 FL Practitioner - Nurse Practitioner 6406221886 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Suntree Internal Medicine, Inc.Group PAC ID 1951378694, 16 clinicians

Practice addresses (Care Compare)

6619 N Wickham Rd
Melbourne, FL 32940-2006
Phone (321) 259-9500

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
11024253FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Suntree Internal Medicine, LLC. Single Specialty CurrentSince Mar 1, 2025 Accepting new patients
Suntree Endocrinology Single Specialty Current Accepting new patients
My Home Doctor, LLC Past Accepting new patients
Orlando Family Physicians, LLC PastSince Jan 5, 2025 Accepting new patients
Idelis Fedeslinda Arias de la Torre PastSince Jun 1, 2021 Accepting new patients

Locations

6619 N Wickham Rd
Melbourne, FL 32940
Phone (321) 259-9500

Networks

  • Freedom Health HMO Network

Organizations & group practices 5

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

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1675382400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783382400000",
    "number": "1073219820",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6619 N WICKHAM RD",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329402006",
            "telephone_number": "321-259-9500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6619 N WICKHAM RD",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329402006",
            "telephone_number": "407-956-1920"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6156 Breslay Dr Ste 101",
            "address_purpose": "LOCATION",
            "city": "Viera",
            "state": "FL",
            "postal_code": "329408727",
            "country_code": "US",
            "telephone_number": "321-259-9500",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MARTINEZ",
        "first_name": "EDISON",
        "middle_name": "ALEXANDER",
        "credential": "APRN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-02-03",
        "last_updated": "2026-07-07",
        "certification_date": "2026-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "11024253",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Melbourne, FL

Sources for this page

Verify at the official NPI Registry.