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General NPI Number Information
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NPI Number | 1003476011
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Entity Type | Individual
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Provider Name | ANGELA MARIE MARTIN APRN
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Gender | Female
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Dates
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Enumeration Date | 06/20/2019
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Last Update Date | 01/08/2026
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Provider Practice Location Address
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Address Line | 15953 N FLORIDA AVE
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City | LUTZ
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State | FL
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Zip | 33549-2607
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Country | US
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Telephone | 813-513-0808
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Fax |
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Provider Business Mailing Address
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Address Line | 5842 RIVER RD
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City | NEW PORT RICHEY
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State | FL
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Zip | 34652-2521
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Country | US
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Telephone | 352-247-9590
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 11002664
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License Number State | FL
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