Jacqueline Martinez

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PTT33391 Issued in FL

Practice address

100 Executive Way
Ponte Vedra, FL 32082-2715

Phone

(904) 543-9011

NPI assigned

Feb 16, 2018

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1518739200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1518739200000",
    "number": "1306346382",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "613 SW 103RD AVE",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331741732"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 EXECUTIVE WAY",
            "city": "PONTE VEDRA",
            "state": "FL",
            "postal_code": "320822715",
            "telephone_number": "904-543-9011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTINEZ",
        "first_name": "JACQUELINE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-02-16",
        "last_updated": "2018-02-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PTT33391",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Domenico Michael Manago, PT
• Marathon Health LLC
• Karen Rachel Marcus-Hendry, LMHC
• Marianna Garibaldi Pmhnp LLC
• Cynthia Martinez
• Tiffany Lynne Matheny
• Jennifer Berry Matthesen, MD
• Carol Anne McCabe, DDS
• Mallory Ann McClain, RBT
• Lyndsee McDonald, OTR/L

• Physical Therapist in Ponte Vedra, FL
• Providers in Ponte Vedra, FL by specialty
• Physical Therapist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.