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General NPI Number Information
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NPI Number | 1154617413
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Entity Type | Individual
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Provider Name | KIMBERLY M MARTIN ARNP
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Gender | Female
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Dates
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Enumeration Date | 06/24/2011
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Last Update Date | 08/07/2025
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Provider Practice Location Address
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Address Line | 3000 N WICKHAM RD STE 5
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City | MELBOURNE
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State | FL
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Zip | 32935-2330
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Country | US
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Telephone | 321-345-1880
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Fax |
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Provider Business Mailing Address
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Address Line | 3000 N WICKHAM RD STE 5
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City | MELBOURNE
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State | FL
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Zip | 32935-2330
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Country | US
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Telephone | 321-652-2381
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | APRN9233303
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 363LP0200X
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Taxonomy Name | Pediatric Nurse Practitioner
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License Number | ARNP9233303
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 363LP2300X
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Taxonomy Name | Primary Care Nurse Practitioner
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License Number | APRN9233303
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License Number State | FL
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Taxonomy #4
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | RN9233303
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License Number State | FL
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Taxonomy #5
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | APRN9233303
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License Number State | FL
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