Organization Active NPI

Ultra Health Providers of Florida

  • Nurse Practitioner
  • Nashville, TN
National Provider Identifier
1528549490
Registry record updated Jul 14, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
Legal business name
ULTRA HEALTH PROVIDERS OF FLORIDA
Practice address
217 6TH Ave N Ste 43952
Nashville, TN 37219-1903
Phone
(731) 394-1145
NPI assigned
Aug 28, 2018
Last updated
Jul 14, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 14, 2026

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

Authorized official

Name
Timothy Martinez
Title
Ceo
Phone
(731) 394-1145

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Geriatric Medicine (Internal Medicine) Physician 207RG0300X
Nurse Practitioner 363L00000X Primary

Addresses

Primary practice location

217 6TH Ave N Ste 43952
Nashville, TN 37219-1903

Mailing address

PO Box 269092
Dept 1103
Oklahoma City, OK 73126-9092
Phone (731) 394-1145

Other practice location 1

2202 W Oak Ave
Plant City, FL 33563-7222
Phone (386) 562-4899

Other practice location 2

701 N Wilder Rd
Plant City, FL 33566-7547
Phone (386) 562-4899

Other practice location 3

10300 4th St N
Saint Petersburg, FL 33716-3810
Phone (386) 562-4899

Other identifiers 4

IdentifierTypeStateIssuer
123172200MedicaidFL
123172202MedicaidFL
123172203MedicaidFL
123172201MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190219000020 FL Part B Supplier - Clinic/Group Practice 9335487255 Receives reassigned benefits from 5 practitioners
Practice locations: Wilton Manors, FL; Saint Petersburg, FL; Plant City, FL; Lake Mary, FL; Gainesville, FL; Orlando, FL; Crescent City, FL; Fort Lauderdale, FL…

National Provider Directory

National Provider Directory

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Locations

100 W Indiana Ave
Deland, FL 32720

2202 W Oak Ave
Plant City, FL 33563
Phone (813) 502-1333

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/18512/brand/1/csg/1/fhir/r4

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1535414400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1783987200000",
    "number": "1528549490",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 269092",
            "address_2": "DEPT 1103",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731269092",
            "telephone_number": "731-394-1145"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "217 6TH AVE N STE 43952",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372191903",
            "telephone_number": "731-394-1145"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2202 W Oak Ave",
            "address_purpose": "LOCATION",
            "city": "Plant City",
            "state": "FL",
            "postal_code": "335637222",
            "country_code": "US",
            "telephone_number": "386-562-4899",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "701 N Wilder Rd",
            "address_purpose": "LOCATION",
            "city": "Plant City",
            "state": "FL",
            "postal_code": "335667547",
            "country_code": "US",
            "telephone_number": "386-562-4899",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "10300 4th St N",
            "address_purpose": "LOCATION",
            "city": "Saint Petersburg",
            "state": "FL",
            "postal_code": "337163810",
            "country_code": "US",
            "telephone_number": "386-562-4899",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "ULTRA HEALTH PROVIDERS OF FLORIDA",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-08-28",
        "last_updated": "2026-07-14",
        "certification_date": "2026-07-14",
        "status": "A",
        "authorized_official_last_name": "MARTINEZ",
        "authorized_official_first_name": "TIMOTHY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "731-394-1145"
    },
    "taxonomies": [
        {
            "code": "207RG0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "123172200",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "123172202",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "123172203",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "123172201",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Nashville, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.