=====================================================
General NPI Number Information
=====================================================
NPI Number | 1427035294
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | DEBORAH G. MARTIN A.R.N.P.
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 12/22/2005
-----------------------------------------------------
Last Update Date | 06/23/2016
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2454 N MCMULLEN BOOTH RD STE 601
-----------------------------------------------------
City | CLEARWATER
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33759-1353
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 727-796-7705
-----------------------------------------------------
Fax | 727-796-8764
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2454 N MCMULLEN BOOTH RD STE 601
-----------------------------------------------------
City | CLEARWATER
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33759-1353
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 727-796-7705
-----------------------------------------------------
Fax | 727-796-8764
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363LX0001X
-----------------------------------------------------
Taxonomy Name | Obstetrics & Gynecology Nurse Practitioner
-----------------------------------------------------
License Number | ARNP 1645032
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 363LX0106X
-----------------------------------------------------
Taxonomy Name | Occupational Health Nurse Practitioner
-----------------------------------------------------
License Number | ARNP 1645032
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------
Taxonomy #3
-----------------------------------------------------
Taxonomy Code | 363LA2200X
-----------------------------------------------------
Taxonomy Name | Adult Health Nurse Practitioner
-----------------------------------------------------
License Number | ARNP 1645032
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------