DR. JESSIE MARTIN (NPI# 1073547972) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1073547972 |
| Entity Type | Individual |
| Full Name | DR. JESSIE MARTIN |
| Credential | MD |
| Practice Address |
1415 Colonial Blvd Ste 1 Fort Myers FL 33907 |
| Mailing Address |
8140 Liriope Loop Lehigh Acres FL 33972-7546 |
| Practice Telephone | 2392024517 |
| Mailing Telephone | 6462676718 |
| Enumeration Date | 2006-07-10 |
| Last Update Date | 2018-07-24 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208D00000X | General Practice | ACN783 | FL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| KS | PERFORMING INDIV. NUMBER | 105600 | 01 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1301 Ks Hwy 264, Larned, KS 675509365 | 6202854580 | 6202854579 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215158217 | Jessie Martin | Licensed Practical Nurse | 29 E. Philadelphia, Youngstown, OH 44507 | 2007-05-01 |
| 1750981825 | Jessie Martin | Chore Provider | 1325 Airmotive Way, Reno, NV 89502-3201 | 2020-10-28 |
| 1952861197 | Jessie Nicole Martin | Student in an Organized Health Care Education/Training Program | 5001 Hardy St, Hattiesburg, MS 39402-1308 | 2019-03-22 |
| 1285619049 | Jessie J Martin | Emergency Medicine | 4535 Dressler Rd Nw, Canton, OH 44718-2545 | 2005-12-14 |
| Street Address |
1415 COLONIAL BLVD STE 1 |
| City | FORT MYERS |
| State | FL |
| Zip Code | 33907 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134739253 | Islande Dorcin | Social Worker | 13300 South Cleveland Ave Suite 56 # 822, Fort Myers, FL 33907 | 2020-08-04 |
| 1003462268 | Ronny Rodolfo Herrera | Behavior Technician | Beacon Executive Suites, 8359 Beacon Blvd, Suite#416, Homestead, FL 33907 | 2019-08-14 |
| 1528549094 | Deborah Senese Streater | Dentist | 12530 New Brittany Blvd., Fort Myers, FL 33907 | 2018-08-23 |
| 1437648391 | Rita Lusinete Rabitt | Registered Nurse | 14084 Clear Water Ln, Fort Myers, FL 33907 | 2018-05-07 |
| 1972092146 | Surgery Centre of Sw Florida LLC | Clinic/Center | 13051 University Dr Ste 102, Fort Myers, FL 33907 | 2018-05-03 |
| 1740787761 | Care Transport Inc | Non-emergency Medical Transport (VAN) | 7850 Reflection Cove Dr, Fort Myers, FL 33907 | 2018-04-06 |
| 1942730692 | Concierge Care of Fort Myers, LLC | In Home Supportive Care | 12253 New Brittany Boulevard, Suite 32, Fort Myers, FL 33907 | 2017-06-15 |
| 1710411467 | Johnnie Terrell | Social Worker | 43 Barkley Cir #102, Fort Myers, FL 33907 | 2017-04-19 |
| 1881041184 | Hchs Medical Center | Clinic/Center | 35 Barkley Circle, Unit 2, Fort Myers, FL 33907 | 2016-05-17 |
| 1043665227 | Tong Liu | Dentist | 8016 Summerlin Lakes Dr, Fort Myers, FL 33907 | 2016-04-26 |
| Find all providers in zip 33907 | ||||
| Taxonomy Code | 208D00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | General Practice |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922646306 | Duxana Medical Center Corp | General Practice | 5248 Red Cedar Dr Ste 102, Fort Myers, FL 33907-4522 | 2019-12-16 |
| 1821573684 | Healthwise Medical Practice LLC | General Practice | 1415 Colonial Blvd, Fort Myers, FL 33907-1043 | 2018-09-27 |
| 1447754825 | Luis Daniel Ramos | General Practice | 15590 Ocean Walk Cir Apt 201, Fort Myers, FL 33908 | 2018-03-21 |
| 1952820656 | Robert A Didonato | General Practice | 3677 Central Ave Ste K, Fort Myers, FL 33901-8226 | 2017-09-13 |
| 1508094335 | Alexander R White | General Practice | 9671 Gladiolus Dr Ste 109, Fort Myers, FL 33908-7684 | 2009-07-01 |
| 1144472101 | Eugene Angelo Cozza | General Practice | 59 Timberland Circle, Fort Myers, FL 33919 | 2008-10-21 |
| 1346365368 | Vincent Go | General Practice | 13801 White Gardenia Way, Fort Myers, FL 33912-5678 | 2007-03-20 |
| 1649385790 | Francisco Maximo Vazquez | General Practice | 4595 Palm Beach Blvd, Suite 1, Fort Myers, FL 33905-3400 | 2006-08-20 |
| 1902379209 | Lee Memorial Health System | General Practice | 12550 New Brittany Blvd, Fort Myers, FL 33907-3655 | 2019-01-09 |
| 1316398118 | Dwic of Tampa Bay, Inc | General Practice | 12375 S Cleveland Ave, Fort Myers, FL 33907-3803 | 2016-06-23 |
| Find all providers in FORT MYERS | ||||
| City | FORT MYERS |
| Zip Code | 33907 |
Please comment or provide details below to improve the information on DR. JESSIE MARTIN.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.