Active NPI
Brooke Martinez
- Rehabilitation Practitioner
- Port Orange, FL
National Provider Identifier
1497272355
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Rehabilitation Practitioner
- License
- PTA27709
- Practice address
- 1525 Herbert St
Port Orange, FL 32129-6106 - Phone
- (386) 756-0424
- NPI assigned
- Aug 23, 2017
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Rehabilitation Practitioner | 225400000X | PTA27709 | FL | Primary |
Addresses
Primary practice location
1525 Herbert St
Port Orange, FL 32129-6106
Mailing address
1525 Herbert St
Port Orange, FL 32129-6106
Phone (386) 756-0424
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PTA27709 | FL | MD | Rehabilitation Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1503446400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1503446400000",
"number": "1497272355",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1525 HERBERT ST",
"city": "PORT ORANGE",
"state": "FL",
"postal_code": "321296106",
"telephone_number": "386-756-0424"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1525 HERBERT ST",
"city": "PORT ORANGE",
"state": "FL",
"postal_code": "321296106",
"telephone_number": "386-756-0424"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARTINEZ",
"first_name": "BROOKE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-08-23",
"last_updated": "2017-08-23",
"status": "A"
},
"taxonomies": [
{
"code": "225400000X",
"taxonomy_group": "",
"desc": "Rehabilitation Practitioner",
"state": "FL",
"license": "PTA27709",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Port Orange, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.