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Jussep Orlando Fombellida Martinez

Nurse Practitioner

Physician Assistants & Advanced Practice Nursing Providers

PECOS Enrollment

This provider is enrolled in PECOS as JUSSEP FOMBELLIDA MARTINEZ.

Based on the most recent information from CMS, provider Jussep Orlando Fombellida Martinez is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Enrolled

CMS last updated its PECOS records 3 days ago.

Profile Details

Provider ID
1831716067
Provider Type
Individual
Full Name
Fombellida Martinez, Jussep Orlando
Credential
APRN

Gender
Male
Sole Proprietor
No
Enumeration Date
7/4/2020
Last Updated
1/6/2021

Contact Information

Practice Location

5564 E Grant St, Orlando, FL 32822-1666

(321) 235-6230

(321) 235-6246

Mailing Location

5564 E Grant St, Orlando, FL 32822-1666

(321) 235-6230

(321) 235-6246

Provider Taxonomies

Code	Description	License
Code 363LF0000X Primary	Description Nurse Practitioner Physician Assistants & Advanced Practice Nursing Providers	License 11007910 Florida

Jussep Orlando Fombellida Martinez

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Bertot, Kimberly

Sayeed, Haris Mohammed

Koumtani, Fatima

Geltz, Brittany

Enriquez, Kirsten Lim

Fils Aime, Thaynee

Torres Valentin, Karen

Thomas, Dana Maria Lee

Quach, Bennie

Miller, Patricia Audrey