Provider Demographics
NPI:1174977615
Name:MARTINEZ, LESLIE ANN (DC)
Entity type:Individual
Prefix:DR
First Name:LESLIE
Middle Name:ANN
Last Name:MARTINEZ
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1450 OAKFIELD DR
Mailing Address - Street 2:
Mailing Address - City:BRANDON
Mailing Address - State:FL
Mailing Address - Zip Code:33511-4853
Mailing Address - Country:US
Mailing Address - Phone:813-655-7246
Mailing Address - Fax:813-655-7266
Practice Address - Street 1:1450 OAKFIELD DR
Practice Address - Street 2:
Practice Address - City:BRANDON
Practice Address - State:FL
Practice Address - Zip Code:33511-4853
Practice Address - Country:US
Practice Address - Phone:813-655-7246
Practice Address - Fax:813-655-7266
Is Sole Proprietor?:No
Enumeration Date:2016-04-21
Last Update Date:2018-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH11815111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor