Healthcare Provider Details

I. General information

NPI: 1730363870
Provider Name (Legal Business Name): WYNIKA RAYNE MOREIRA APRN, CNM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MS. WYNIKA RAYNE MARTIN

II. Dates (important events)

Enumeration Date: 12/26/2007
Last Update Date: 06/01/2026
Certification Date: 06/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2200 RINGLING BLVD
SARASOTA FL
34237-6102
US

IV. Provider business mailing address

3014 BALDWIN AVE
SARASOTA FL
34232-5208
US

V. Phone/Fax

Practice location:
  • Phone: 718-924-8546
  • Fax:
Mailing address:
  • Phone: 718-924-8546
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License NumberAPRN11020335
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: