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General NPI Number Information
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NPI Number | 1538704580
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Entity Type | Individual
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Provider Name | MARTHA LORENA OBANDO MSN, APRN, FNC-BC
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Gender | Female
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Dates
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Enumeration Date | 11/14/2019
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Last Update Date | 11/18/2019
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Provider Practice Location Address
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Address Line | 16324 SW 15TH ST
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City | PEMBROKE PINES
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State | FL
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Zip | 33027-5126
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Country | US
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Telephone | 786-441-4736
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 668035
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City | MIAMI
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State | FL
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Zip | 33166-9409
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Country | US
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Telephone | 786-441-4736
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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 | 363LP2300X
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Taxonomy Name | Primary Care Nurse Practitioner
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License Number | APRN11005118
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | RN9363418
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License Number State | FL
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