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NPI Code Detail

MEDICARE: MARTINE SURRATT

MEDICARE:   MARTINE  SURRATT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LF0000XFamily Nurse Practitioner2019054066FL

General Provider Information

NPI Number : 1598303844
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARTINE SURRATT
Provider Business Mailing Address
First Line : 10869 PAPERBARK PL
Second Line :
City : BOYNTON BEACH
State : FL
Zip : 33437-7533
Country : US
Telephone Number : 561-376-5963
Fax Number :
Provider Business Practice Location Address
First Line : 10869 PAPERBARK PL
Second Line :
City : BOYNTON BEACH
State : FL
Zip : 33437-7533
Country : US
Telephone Number : 561-376-5963
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/17/2019
Last Update Date : 12/17/2019

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Directions to “ MARTINE SURRATT ” Practice Location

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