Inna Victor Martire, P.A.

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

PA9104005 Issued in FL

Practice address

12612 Challenger Pkwy Ste 365
Orlando, FL 32826-2784

Phone

(407) 707-9804

NPI assigned

Dec 1, 2006

Sex

Female

Sole proprietor

No

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)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

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.

• Coastal Radiology Associates PA

  • Diagnostic Radiology Physician
  • Fort Walton Beach, FL
  • NPI 1750524393
  NPD (past)

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

{
    "created_epoch": "1164931200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693180800000",
    "number": "1497823942",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12612 CHALLENGER PKWY STE 365",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328262784",
            "telephone_number": "407-707-9804"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12612 CHALLENGER PKWY STE 365",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328262784",
            "telephone_number": "407-707-9804"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIRE",
        "first_name": "INNA",
        "middle_name": "VICTOR",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-01",
        "last_updated": "2023-08-28",
        "certification_date": "2023-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "FL",
            "license": "PA9104005",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dino M Martino, R.PH.
• Hilary Martino
• Nelly E Martins
• Renata Fernandes Martins
• Tina Elizabeth Martinusen, PT, DPT
• Carlos C Martoral, OTR/L
• Edgar Arturo Martorell, M.D.
• Javonni Martori
• Andrea Martyn
• Christopher P Martz, O.D.

• All providers in Orlando, FL
• Medical Physician Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2023; 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.