Healthcare Provider Details

I. General information

NPI: 1427035294
Provider Name (Legal Business Name): DEBORAH G. MARTIN A.R.N.P.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/22/2005
Last Update Date: 06/23/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2454 N MCMULLEN BOOTH RD STE 601
CLEARWATER FL
33759-1353
US

IV. Provider business mailing address

2454 N MCMULLEN BOOTH RD STE 601
CLEARWATER FL
33759-1353
US

V. Phone/Fax

Practice location:
  • Phone: 727-796-7705
  • Fax: 727-796-8764
Mailing address:
  • Phone: 727-796-7705
  • Fax: 727-796-8764

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LX0001X
TaxonomyObstetrics & Gynecology Nurse Practitioner
License NumberARNP 1645032
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code363LX0106X
TaxonomyOccupational Health Nurse Practitioner
License NumberARNP 1645032
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberARNP 1645032
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: