Healthcare Provider Details

I. General information

NPI: 1023383023
Provider Name (Legal Business Name): IDANIA MARTIN DNP, ARNP, ANP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/09/2012
Last Update Date: 08/22/2026
Certification Date: 08/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12515 SW 88TH ST
MIAMI FL
33186-1829
US

IV. Provider business mailing address

8145 NW 7TH ST APT 504
MIAMI FL
33126-8004
US

V. Phone/Fax

Practice location:
  • Phone: 305-308-9937
  • Fax:
Mailing address:
  • Phone: 305-308-9937
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberARNP9279693
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN9279693
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberAPRN9279693
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: