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General NPI Number Information
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NPI Number | 1912993353
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Entity Type | Individual
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Provider Name | CYNTHIA ANN MARTIN CPNP
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Gender | Female
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Dates
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Enumeration Date | 09/21/2005
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Last Update Date | 05/31/2018
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Provider Practice Location Address
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Address Line | 8934 CONROY WINDERMERE RD
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City | ORLANDO
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State | FL
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Zip | 32835-3128
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Country | US
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Telephone | 407-351-0082
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Fax | 407-374-1637
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Provider Business Mailing Address
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Address Line | 1501 SAN PEDRO DR SE BLDG 47 SGOMP/PEDIATRIC CLINIC
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City | ALBUQUERQUE
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State | NM
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Zip | 87108-5153
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Country | US
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Telephone | 505-846-0001
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Fax | 505-853-6290
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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 | 363LP0200X
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Taxonomy Name | Pediatric Nurse Practitioner
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License Number | 087000407N2 PNP
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License Number State | OR
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Taxonomy #2
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | ARNP9412611
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License Number State | FL
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